[Long-term course of esophageal stenosis treated with pneumatic dilatation. A comparative study versus other methods]

Dilatation of benign esophageal strictures by means of a balloon catheter is a well established procedure in children. In this report a comparison of bouginage and balloon dilatation is made in eight patients treated by both procedures. The lesions treated included two strictures secondary to surgical anastomosis, one restrictive Nissen fundoplicature and five esophageal stenosis following caustic ingestion. These eight patients had a total of 44 bouginage procedures with a mean relapse free period of 80 days. There were two esophageal perforations. The clinical course was unsatisfactory in five cases. Only one patient had good results. In contrast, to date, the 15 balloon dilatations have resulted in a mean relapse free time of 174 days. There were no complications that required treatment. The clinical follow up shows four asymptomatics patients and the other four presenting difficulties to swallow with spontaneous resolution. We have the best results in younger patients with esophageal stenosis secondary to esophageal atresia repair. Balloon dilatation of esophageal stenosis in children is effective and safe, and should be considered before other methods of treatment are used.