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Management of refractory esophageal stenosis in the pediatric age

Fernando Alberca de Las Parras1, María Navalón Rubio2, Juan Egea Valenzuela2

  • 1Digestivo/Endoscopias, Hospital Clínico Universitario Virgen de la Arrixaca, España.

Revista Espanola De Enfermedades Digestivas
|September 22, 2016
PubMed

Insights

Biodegradable stents (BS) combined with C-mitomycin (CM) show promise for treating refractory esophageal stenosis in children. This combined approach effectively managed 83.3% of stenoses and 50% of fistulas in a small pediatric cohort.

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Innovation
  • Medical Device Development

Background:

  • Refractory esophageal stenosis (RES) presents a significant challenge in pediatric care.
  • Existing treatments like stent placement and C-mitomycin (CM) have limitations.
  • Biodegradable stents (BS) offer a novel therapeutic option.

Observation:

  • This study evaluated the combined use of biodegradable stents (BS) and C-mitomycin (CM) in six pediatric patients with RES.
  • Patients presented with post-operative fistulas, esophageal atresia, or caustic strictures.
  • BS were used in four patients, with CM employed in five, sometimes after stent failure.

Findings:

  • Biodegradable stents (BS) showed variable success in treating fistulas and stenosis.
  • C-mitomycin (CM) demonstrated effectiveness in treating stenosis, particularly after stent failure.
  • The combined approach of BS and CM achieved an 83.3% success rate for stenosis and 50% for fistulas.

Implications:

  • The combination of biodegradable stents and C-mitomycin is a viable and effective strategy for pediatric refractory esophageal stenosis.
  • This approach may offer improved outcomes compared to single-modality treatments.
  • Further research is warranted to optimize treatment protocols and long-term efficacy.
Abstract

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