Endoscopy-guided balloon dilatation of oesophageal strictures in children

Area of Science:

• Pediatric Gastroenterology
• Minimally Invasive Surgery
• Gastrointestinal Endoscopy

Background:

• Esophageal strictures in children can result from various causes, including post-surgical complications and caustic ingestion.
• Conventional bouginage often requires multiple sessions and may not be effective for all pediatric esophageal strictures.
• Endoscopic interventions are increasingly explored for managing complex pediatric gastrointestinal conditions.

Purpose of the Study:

• To evaluate the indications, safety, and efficacy of endoscopy guided balloon dilatation (EGBD) for treating esophageal strictures in pediatric patients.
• To assess EGBD as an alternative treatment for children who have not responded to conventional bouginage.
• To analyze the outcomes of EGBD in different types of pediatric esophageal strictures, including anastomotic and caustic strictures.

Main Methods:

• A retrospective analysis of 12 pediatric patients treated with EGBD between 1998 and 2002.
• Patients included those with strictures post-esophageal atresia repair, short-segment caustic strictures, and anastomotic strictures.
• Procedures were performed using flexible endoscopy and fluoroscopic guidance under general anesthesia, with pre-procedural contrast studies.

Main Results:

• Ten out of twelve patients achieved complete functional results, with two experiencing temporary success.
• The mean number of EGBD procedures per patient was six (range 4-10).
• No morbidity or mortality was reported during or after the EGBD procedures.

Conclusions:

• Endoscopy guided balloon dilatation (EGBD) is a safe and effective treatment modality for pediatric esophageal strictures.
• EGBD demonstrates significant efficacy in managing anastomotic and short-segment caustic esophageal strictures in children.
• The procedure offers a viable and safe option for pediatric patients with refractory esophageal strictures.