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Endoscopic dilation in pediatric esophageal strictures: a literature review

Alessia Ghiselli1, Barbara Bizzarri, Daniela Ferrari

  • 1Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy. alessia.ghiselli@gmail.com.

Acta Bio-Medica : Atenei Parmensis
|December 19, 2018
PubMed

Insights

Endoscopic dilation is a safe and effective first-line treatment for pediatric esophageal strictures. This review found a low complication rate, with most cases successfully managed without surgery.

Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Endoscopy
  • Surgical Innovation

Background:

  • Esophageal strictures are common in children, with varied causes including congenital, acquired, and functional origins.
  • Symptoms often necessitate intervention, with endoscopic dilation being the preferred treatment approach.
  • This review focuses on the efficacy of endoscopic dilation for pediatric esophageal strictures.

Purpose of the Study:

  • To evaluate the efficacy and safety of endoscopic dilation for treating esophageal strictures in pediatric patients.
  • To synthesize findings from existing literature on this pediatric intervention.
  • To assess complication rates and the need for surgical conversion.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases (PubMed/Medline, Scopus, Google Scholar).
  • Keywords included "esophageal strictures," "endoscopic dilations," and "children."
  • Inclusion criteria focused on clinical studies of pediatric esophageal stricture dilation, excluding single-etiology or adult-only studies and reviews.

Main Results:

  • Seventeen studies from 1989-2018 involving 738 pediatric patients were analyzed.
  • Both bougie and balloon dilators were used, with severe complications in 4.5% of patients (33/738), primarily perforation (29/33).
  • Surgical conversion was required in only 2.2% of cases (16/738).

Conclusions:

  • Endoscopic dilation is a safe and effective first-choice treatment for pediatric esophageal strictures.
  • Both fixed dilators and balloon dilators demonstrate positive clinical outcomes.
  • Procedures should be performed in specialized centers by experienced teams to minimize complications.
Abstract

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