ESOPHAGEAL STRICTURES FOLLOWING ESOPHAGEAL ATRESIA REPAIR IN CHILDREN IN SULAIMANI CITY; FREQUENCY AND RESPONSE TO ENDOSCOPIC BALLOON DILATATION

Summary We investigated changes in anastomotic stricture indexes (SIs) and stricture diameter (SD) between before and 6 months after the first dilatation in children with anastomotic stricture after esophageal atresia (EA) repair and identified predictors of medium-term dilatation success (success for at least 3 months). We retrospectively reviewed the records and measurement indexes of patients who underwent post-EA repair endoscopic balloon dilatation between November 2017 and August 2019 in our hospital. We identified diagnostic and performance indicators that predicted medium-term dilatation success by univariate and multivariate analyses and receiver operator characteristic (ROC) curve analysis. Sixty patients (34 boys and 26 girls) showed post-EA repair anastomotic stricture. Paired sample t-tests showed that SD (P < 0.001), upper pouch SI (U-SI, P < 0.001), lower pouch SI (L-SI, P < 0.001), upper pouch esophageal anastomotic SI (U-EASI, P < 0.001) and lower pouch EASI (L-EASI, P < 0.001) were significantly better at 6 months after than before the first dilatation. Logistic regression analysis showed that dilatation number (P = 0.002) and U-SI at 6 months after the first dilatation (P = 0.019) significantly predicted medium-term dilatation success. ROC curve analysis revealed that combining U-SI (cut-off value = 55.6%) and dilatation number (cut-off value = 10) had good accuracy in predicting medium-term dilatation success 6 months after the first dilatation (area under the curve-ROC: 0.95). In conclusion, endoscopic balloon dilatation significantly improved SD and SIs in children with post-EA repair anastomotic stricture. Dilatation number and U-SI at 6 months after the first dilatation were useful in predicting medium-term dilatation success and could represent a supplementary method to improve judgment regarding whether further dilatation is needed 6 months after the first dilatation.

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Endoscopic balloon dilatation of esophageal strictures in children

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2011.07.031 ◽

2011 ◽

Vol 75 (11) ◽

pp. 1376-1379 ◽

Cited By ~ 35

Author(s):

J. Alshammari ◽

S. Quesnel ◽

S. Pierrot ◽

V. Couloigner

Keyword(s):

Balloon Dilatation ◽

Endoscopic Balloon Dilatation ◽

Esophageal Strictures ◽

Endoscopic Balloon

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Factors predicting successful endoscopic balloon dilatation of esophageal strictures in children - a retrospective study

10.21203/rs.2.10642/v1 ◽

2019 ◽

Author(s):

Dongling Dai ◽

Sixi Liu ◽

Qinghua Yang ◽

Chenxi Zhang ◽

Yigui Zou ◽

...

Keyword(s):

Balloon Dilatation ◽

Esophageal Stricture ◽

Successful Outcome ◽

Endoscopic Balloon Dilatation ◽

Esophageal Strictures ◽

Optimal Protocol ◽

Multiple Structures ◽

Predicting Outcome ◽

Poor Outcomes ◽

Endoscopic Balloon

Abstract Background & Aims: Endoscopic balloon dilatation has become the first line treatment for benign esophageal strictures; It is important to know the factors predicting successful outcome to assist in selecting optimal protocol to obtain the best outcome and avoid as many complication as possible. This study aimed to assess the factors predicting outcome of endoscopic balloon dilatation treatment for esophageal stricture in children. Methods: All the patients with benign esophageal stricture treated by endoscopic balloon dilatation from January 2010 to December 2014 were included. All procedures were performed under tracheal intubation and intravenous anesthesia using the 3rd grade controlled radial expansion balloon with the gastroscope. Outcomes were recorded and predictors for outcomes were analyzed. Results: A total of 170 dilations were completed in 64 patients. The success rate was 96.9%. The rates of response, complication, and recurrence were 96.77%, 8.06%, and 3.33%, respectively. The number of dilatation sessions and complications were significant higher in patients with smaller diameter strictures (P = 0.013, 0.023), and in patients with multiple structures (P = 0.014, 0.004); more complication and recurrences were seen in patients with longer strictures (P = 0.001, 0.012). The longer the interval between surgery and first dilatation the more sessions and the poorer the response in the patients with anastomotic esophageal strictures (p = 0.017, 0.024). Conclusions: The diameter, length and number of stricture were the most important risk factors for poor outcomes of endoscopic balloon dilatation treatment of esophageal stricture.

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The Most Common Causes of Benign Esophageal Stricture in Children and the Success Rate of Endoscopic Balloon Dilatation, a Single-Center Experience

Journal of Comprehensive Pediatrics ◽

10.5812/compreped.105903 ◽

2020 ◽

Vol 11 (4) ◽

Author(s):

Hamid Reza Sadeghi ◽

Mehri Najafi Sani ◽

Fatemeh Farahmand ◽

Hosein Alimadadi ◽

Farzaneh Motamed ◽

...

Keyword(s):

Balloon Dilatation ◽

Esophageal Stricture ◽

Response To Treatment ◽

Caustic Ingestion ◽

Benign Esophageal Stricture ◽

Endoscopic Balloon Dilatation ◽

Balloon Catheters ◽

Esophageal Strictures ◽

Common Causes ◽

Endoscopic Balloon

Background: Benign esophageal strictures are not rare. Over the past two decades, endoscopic balloon dilatation (EBD) has been used to treat them. Objectives: The purpose of this study was to identify the most common causes of benign esophageal stricture in children determine the success rate of endoscopic balloon dilatation. Methods: Children younger than 16 years with benign esophageal strictures referred to the endoscopy department during one year (2016 - 2017) were enrolled. After obtaining written consent from parents, endoscopy balloon dilatation was performed with two types of balloon catheters. Response to treatment was evaluated based on clinical symptoms and was classified according to the Vantrappen table score. Results: In this study, thirty-one (31) children participated including 19 (61%) boys and 12 (39%) girls. The mean age was 5.1 ± 3.9 years. The most common causes of esophageal stricture were: achalasia (45%), esophageal atresia (19%), stenosis due to the caustic ingestion (19%), another congenital stenosis (16%). Overall, 27 children (87.1%) had a good response to treatment. In children with stenosis due to caustic ingestion, the inappropriate response was higher than the rest (33%). However, only in 4 (12.9%) patients, balloon dilatation failed. No complications were observed. Conclusions: Achalasia, esophageal atresia, and caustic ingestion are the most common cause of benign esophageal stricture in the children. EBD is an effective and safe treatment in these children, even in cases of previous surgery and recurrence. If this procedure is performed by an expert using appropriate balloon catheters, no complications will be created.

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