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Published on: April 17, 2020
Esophageal stents for severe strictures in young children: experience, benefits, and risk
Robert E Kramer1, J Antonio Quiros
1Section of Pediatric Gastroenterology, Hepatology and Nutrition, The Children's Hospital/University of Colorado Denver, 13123 East 16th Avenue, B-290, Aurora, CO, 80124, USA. Kramer.robert@tchden.org
Insights
Removable esophageal stents offer a new treatment for pediatric esophageal strictures, providing continuous dilation pressure. This review covers their use, types, placement, and complications in children.
Area of Science:
- Pediatric Gastroenterology
- Interventional Endoscopy
- Esophageal Diseases
Background:
- Esophageal stents are widely used in adults for malignant lesions.
- Pediatric use was limited by non-removable stents and implications for growing children, especially with benign strictures.
Purpose of the Study:
- To review the pediatric literature on esophageal stents.
- To discuss indications, types, placement, management, and complications of esophageal stents in children.
Main Methods:
- Review of published pediatric literature on esophageal stents.
- Analysis of stent types, indications, technical guidance, and outcomes.
Main Results:
- Removable, covered stents have expanded the use of stenting in children.
- Stenting provides continuous radial dilation pressure, potentially superior to traditional dilation methods.
Conclusions:
- Esophageal stenting is a viable option for various pediatric esophageal strictures.
- Understanding stent types, proper placement, and management is crucial for successful outcomes and minimizing complications.
Abstract:
The use of esophageal stents has been commonplace in adults for many years and for a variety of indications, including palliative care for malignant lesions involving the esophagus. The use of esophageal stents in the pediatric population, however, was limited by the inability to remove them and the implications this has for the growing child, especially for primarily benign esophageal lesions. With the advent of removable, covered stents, the potential uses for stents in children expanded to include treatment of a wide variety of congenital and acquired esophageal strictures. Stenting offers tremendous potential advantage over more traditional pneumatic or bougie dilation in its ability to provide continuous, radially oriented dilation pressure sustained over a period of time. This review examines the published pediatric literature on stents, discusses the indications for their use, outlines the types of stents available, offers technical guidance for proper placement, and reviews subsequent management and complications.
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