Esophageal endoscopic dilations

Area of Science:

• Pediatric Gastroenterology
• Endoscopic Surgery
• Digestive Tract Disorders

Background:

• Esophageal strictures in children are a significant clinical challenge requiring specialized management.
• Peptic strictures are the most prevalent type in this pediatric population, while caustic and congenital strictures are less common.

Purpose of the Study:

• To evaluate the efficacy and outcomes of endoscopic dilation for treating various types of esophageal strictures in children.
• To analyze the response to endoscopic treatment based on the etiology of the stricture.

Main Methods:

• A 7-year retrospective case study involving 60 pediatric patients with esophageal strictures treated via endoscopic dilation using Savary-Gilliard bougies.
• Patients were categorized into three groups: peptic strictures (52), caustic strictures (4), and post-esophageal atresia surgery strictures (4).
• A total of 247 dilation sessions were performed under deep sedation, with an average of 4 sessions per patient.

Main Results:

• A good response to dilation was observed in 70% of patients with peptic strictures and 50% with caustic strictures.
• Patients with post-esophageal atresia surgery strictures required more frequent and repeated dilation sessions.
• Two esophageal perforations occurred, one in the peptic stricture group and one in the caustic stricture group.

Conclusions:

• Endoscopic dilation is an effective treatment modality for pediatric esophageal strictures, particularly peptic strictures.
• This technique can obviate the need for surgical intervention in select cases.
• The procedure demonstrated a low rate of complications, such as perforation.