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

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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Endoscopic Balloon Dilatation of Benign Esophageal Stricture—A Nonhazardous Procedure?

Diagnostic and Therapeutic Endoscopy ◽

10.1155/dte.1.93 ◽

1994 ◽

Vol 1 (2) ◽

pp. 93-97

Author(s):

Olle Ekberg ◽

Anders Borgström ◽

Frans-Thomas Fork ◽

Eje Lövdahl

Keyword(s):

Reflux Esophagitis ◽

Balloon Dilatation ◽

Esophageal Stricture ◽

Benign Esophageal Stricture ◽

Outpatient Procedure ◽

Nasogastric Intubation ◽

Endoscopic Balloon Dilatation ◽

Major Complications ◽

Esophageal Strictures ◽

Endoscopic Balloon

Balloon dilatation of benign esophageal strictures has been widely used since its introduction. We have performed 224 dilatation procedures in 52 patients. Dilatation was done as an outpatient procedure. Strictures were due to reflux esophagitis in 25 patients, anastomatic stenosis in 6, achalasia in 5, complications of sclerotherapy in 5, corrosive lesions in 3, and long-standing nasogastric intubation in 2. The cause was unknown in 6 cases. The intention was to dilate all strictures up to 20 mm. Three major complications occurred, and one of these patients died. The risk of perforation seems to be higher after repeated procedures than during the first one.

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