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Esophageal stricture in children: fiber-optic endoscopy and dilatation under fluoroscopic control
A M Dalzell1, R W Shepherd, G J Cleghorn
1Children's Nutrition Research Centre, Royal Children's Hospital Brisbane, Queensland, Australia.
Insights
Fiber-optic endoscopic esophageal dilatation is effective and well-tolerated for treating pediatric esophageal strictures, whether congenital or corrosive. This outpatient procedure showed a low complication rate in 45 children.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Surgery
- Endoscopic Procedures
Background:
- Esophageal strictures in children can result from congenital conditions like tracheoesophageal fistula and esophageal atresia, or acquired causes such as corrosive ingestion.
- Management of pediatric esophageal strictures often requires interventions to restore esophageal patency and function.
- Endoscopic dilatation is a common therapeutic approach for esophageal strictures.
Purpose of the Study:
- To evaluate the efficacy and complication rate of fiber-optic endoscopic esophageal dilatation in children with esophageal strictures.
- To analyze outcomes based on the etiology of esophageal strictures (congenital vs. corrosive).
Main Methods:
- Retrospective analysis of 268 esophageal dilatation procedures performed on 45 children.
- Procedures were conducted under fluoroscopic guidance using a fiber-optic endoscope.
- Dilatation was performed using antegrade and retrograde techniques under general anesthesia, primarily as an outpatient setting.
Main Results:
- The study included 45 children with esophageal strictures, 36 with post-surgical strictures (tracheoesophageal fistula/esophageal atresia repair) and 9 with corrosive strictures.
- A total of 268 dilatation procedures were performed.
- The fiber-optic endoscopic esophageal dilatation procedure was found to be well-tolerated and effective in this pediatric cohort.
Conclusions:
- Fiber-optic endoscopic esophageal dilatation is a safe and effective treatment modality for esophageal strictures in children.
- The procedure demonstrates good tolerability and efficacy for both congenital and corrosive etiologies of esophageal strictures.
- Outpatient management of esophageal strictures via endoscopic dilatation is feasible and successful in pediatric patients.
Abstract:
We made a retrospective analysis of the efficacy and complication rate of 268 esophageal dilatation procedures performed under fluoroscopic control using the fiber-optic endoscope in 45 children with esophageal stricture. Antegrade and retrograde stricture dilatation was performed under general anesthetic, mainly as an outpatient procedure. Thirty-six children had an esophageal stricture following tracheoesophageal fistula and/or esophageal atresia repair, and nine children had severe corrosive stricture of the esophagus following lye ingestion. The procedure was well tolerated and effective.