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The Outcome of Pediatric Esophageal Strictures Managed with Endoscopic Balloon Dilation in Saudi Arabia
Enaam Raboei1, Abdulrahman Alabdali2, Mohamed Hesham Sayed2
1Department of Pediatric Surgery, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.
Insights
Endoscopic balloon dilation (EBD) offers a higher success rate for pediatric esophageal strictures compared to Savary dilatation. This safe and effective method improves clinical and nutritional outcomes in children.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Surgery
Background:
- Esophageal strictures in children can severely impact nutrition and weight gain.
- Management of pediatric esophageal strictures requires safe and effective dilation techniques.
Purpose of the Study:
- To evaluate and compare the safety, efficacy, and long-term effects of endoscopic balloon dilatation (EBD) versus Savary dilatation for pediatric esophageal strictures.
- To assess clinical and nutritional outcomes, including weight and height changes, following dilation procedures.
Main Methods:
- A retrospective study of 137 pediatric patients with esophageal strictures.
- Comparison of outcomes between patients undergoing EBD, Savary dilatation, or both.
- Key outcome measures included number of dilatations, nutritional status, symptom relief, and complication rates.
Main Results:
- The most common cause was post-tracheoesophageal fistula repair (37.2%); most strictures were in the lower third (34.3%).
- Endoscopic balloon dilation (EBD) demonstrated a higher success rate (90.4%) compared to overall success (79.6%) and Savary dilatation.
- A statistically significant correlation was found between success rate and dilation method (P=.042), with significant weight gain observed in lower strictures (P=.001).
Conclusions:
- Endoscopic balloon dilation (EBD) is associated with the highest success rate in managing pediatric esophageal strictures.
- Endoscopic dilatations are safe and effective, leading to improved clinical and nutritional outcomes in children.
- EBD represents a superior method for dilation in pediatric esophageal strictures.
Abstract:
Esophageal strictures can affect nutrition of infants and children impairing their weight gain. To our knowledge, this is the first article evaluating and comparing between the two methods of dilation in terms of outcome and one of few, if any, to assess both weight and height to evaluate the nutritional outcomes following dilation. To determine the safety, efficacy, and long-term effects of endoscopic dilation in managing pediatric esophageal strictures by assessing the clinical and nutritional outcomes. A retrospective study of 137 patients with esophageal strictures who underwent either endoscopic balloon dilatation or Savary dilatation, or both. Outcome parameters measured include the number of dilatations, nutritional status, and if symptoms had been relieved. The most frequent cause of esophageal strictures was post-tracheoesophageal fistula repair (n = 51, 37.2%), and the majority were lower third strictures (n = 47, 34.3%). However, 8 cases (5.8%) had failed the dilation procedure. Savary dilatation had the highest number of complications. Overall, success rate was 79.6%. Higher success rate was for cases dilated by endoscopic balloon dilation (EBD) (n = 47, 90.4%). There was a statistically significant correlation between the success rate and the method of dilatation (P = .042). Statistically significant increment of weight was recorded for lower strictures (P = .001). EBD was associated with the highest success rate. Endoscopic dilatations are safe and efficient in managing pediatric esophageal strictures with improvement in both clinical and nutritional outcomes.
