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Long-term dilatation of caustic strictures of the oesophagus
1Department of Surgery, Starship Hospital, Auckland, New Zealand.
Insights
Long-term esophageal dilatation effectively treats most caustic strictures of the esophagus (CSO) in children. This minimally invasive approach offers successful outcomes with a low complication rate, avoiding surgery for many young patients.
Area of Science:
- Pediatric Gastroenterology
- Otolaryngology
- Surgical Innovation
Background:
- Caustic strictures of the esophagus (CSO) present a significant management challenge in pediatric care.
- Current treatment strategies for CSO vary, necessitating research into effective long-term solutions.
Purpose of the Study:
- To evaluate the efficacy and safety of long-term dilatation for managing pediatric caustic strictures of the esophagus.
- To assess the success rates and complication profiles of dilatation therapy in this patient population.
Main Methods:
- Retrospective analysis of 109 children admitted for caustic ingestion.
- Focus on 10 children who developed esophageal strictures and underwent long-term dilatation therapy.
- Data collection on duration of dilatation, need for surgery, and incidence of complications such as perforation.
Main Results:
- Seven out of ten pediatric patients with CSO achieved successful outcomes with long-term dilatation.
- Only three patients required surgical intervention, indicating the effectiveness of non-operative management.
- A low esophageal perforation rate of 0.47% (2 perforations in 424 dilatations) was observed.
Conclusions:
- Long-term esophageal dilatation is a successful and safe primary treatment modality for the majority of pediatric caustic strictures of the esophagus.
- This approach offers a favorable alternative to surgery, associated with minimal complications.
Abstract:
Caustic strictures of the oesophagus (CSO) in children are managed in different ways. Our study looks into the results of long-term dilatation of such strictures. Of 109 children admitted to our hospital with caustic ingestion, 10 developed strictures. The dilatations were carried out for periods varying from 9 months to 4 years. While 3 patients needed surgical treatment, 7 did not and did well. The oesophageal perforation rate with dilatations was only 0.47% (2 perforations from a total of 424 dilatations). Long-term dilatations are successful in managing a majority of CSO in children and are associated with minimal complications.