Esophageal stents in children: Bridge to surgical repair

Bethany J Slater1, Ashwin Pimpalwar1, David Wesson1

  • 1Division of Pediatric Surgery, Michael E Debakey Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.

Insights

Esophageal stents aided in managing complex pediatric airway-esophageal issues, acting as a crucial bridge to surgery for fistulas and leaks. However, complications like migration and erosion occurred in stricture cases.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Thoracic Surgery

Background:

  • Complex esophageal conditions in children, including strictures, leaks, and fistulas, present significant management challenges.
  • Conventional treatments are often insufficient for severe or refractory cases, necessitating advanced interventions.

Purpose of the Study:

  • To evaluate the efficacy and role of esophageal stents in managing complex pediatric esophageal anomalies.
  • To assess the outcomes and complications associated with esophageal stent placement in pediatric patients.

Main Methods:

  • Retrospective case series involving three pediatric patients with refractory esophageal conditions.
  • Utilized esophageal stents as a therapeutic or bridging intervention prior to definitive surgical repair.

Main Results:

  • Esophageal stents facilitated extubation in a child with a tracheo-esophageal-pleural fistula and resolved pulmonary infection in another with an esophago-bronchial fistula, both preceding surgery.
  • The third patient, treated for esophageal stricture, experienced stent-related complications including migration, esophageal erosion, and fistula formation.

Conclusions:

  • Esophageal stents can be a valuable tool in the management of complex pediatric esophageal problems, particularly as a bridge to definitive surgical repair.
  • Careful patient selection and monitoring are essential due to the potential for significant complications, such as migration and erosion.

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