Management of Benign Esophageal Strictures in Children

Area of Science:

• Pediatric Gastroenterology
• Esophageal Disorders
• Pediatric Surgery

Background:

• Esophageal strictures are rare in children, with corrosive ingestion being a primary risk factor in many regions.
• Management of pediatric esophageal strictures presents significant challenges due to the rarity and specific patient population.
• Established treatments require careful consideration of safety and long-term efficacy in pediatric patients.

Purpose of the Study:

• To review the current management strategies for benign esophageal strictures in children.
• To evaluate the safety and efficacy of various treatment modalities, including dilation, steroids, and stenting.
• To provide an overview of the challenges and evidence-based approaches for pediatric esophageal stricture management.

Main Methods:

• Literature review of studies on pediatric esophageal strictures and their management.
• Analysis of treatment outcomes for esophageal dilation (balloon dilatation vs. bouginage).
• Evaluation of adjunctive therapies such as corticosteroids and mitomycin-C, and interventions like stenting.

Main Results:

• Esophageal dilation is a safe and effective long-term treatment for benign esophageal strictures in children.
• Balloon dilatation is frequently preferred over bouginage in younger children and toddlers.
• Corticosteroid therapy shows potential benefit in specific cases (Zargar classification IIb), while mitomycin-C requires further investigation. Stenting has shown success in refractory cases.

Conclusions:

• Esophageal dilation, especially balloon dilatation, is a cornerstone treatment for benign esophageal strictures in pediatric patients.
• Adjuvant therapies like corticosteroids may offer benefits in select cases, warranting further research.
• Stenting represents a viable option for managing refractory pediatric esophageal strictures.