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Esophageal endoscopic dilations

Mounia Lakhdar-Idrissi1, Kawtar Khabbache, Moustapha Hida

  • 1Pediatric Service, University Hospital Hassan II, Fez, Morocco. mounialim@yahoo.fr

Journal of Pediatric Gastroenterology and Nutrition
|January 25, 2012
PubMed

Insights

Pediatric esophageal stricture treatment using endoscopic dilation is effective, particularly for peptic strictures. This minimally invasive approach offers good outcomes with rare complications, avoiding surgery in some cases.

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.
Abstract

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