Custom dynamic stent for esophageal strictures in children

Area of Science:

• Pediatric Gastroenterology
• Medical Device Innovation
• Esophageal Disease Management

Background:

• Esophageal stenosis (ES) often requires repeated dilations due to relapse.
• Traditional self-expandable plastic stents can impede esophageal motility.
• Custom silicone stents offer a novel approach to ES treatment.

Purpose of the Study:

• To evaluate the efficacy of custom silicone stents for treating esophageal stenosis in pediatric patients.
• To assess the impact of custom stents on esophageal motility.
• To compare custom stent outcomes with traditional dilation methods.

Main Methods:

• Custom silicone stents (7-12.7 mm) were designed coaxially on nasogastric tubes.
• Stent ends were tailored for food passage, and stents remained in place for at least 40 days.
• Pediatric patients received dexamethasone and acid suppressants; ethical approval was obtained.

Main Results:

• Stenting was effective in 88.6% (70/79) of pediatric patients with ES.
• 50% of successfully treated patients required only one dilation for stent placement.
• One major stent-related complication occurred; 14 patients received multiple successful stent placements.

Conclusions:

• Custom silicone stents significantly improve treatment outcomes for pediatric esophageal stenosis.
• ES stenting is the primary treatment for caustic injuries.
• For postsurgical ES, stenting is considered after a minimum of five dilations.