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EFFICACY OF ENDOSCOPIC BALLOON DILATION IN IRANIAN PEDIATRIC PATIENTS WITH ESOPHAGEAL STRICTURE
Mitra Ahmadi1, Mohammad Manzari-Tavakoli1, Hazhir Javaherizadeh1,2
1Department of Pediatric Gastroenterology, Abuzar Children's Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Insights
Endoscopic balloon dilation (EBD) effectively treated esophageal strictures in Iranian children, improving clinical outcomes and nutritional status. This minimally invasive procedure showed a 62.3% success rate with minimal complications.
Area of Science:
- Pediatric Gastroenterology
- Interventional Endoscopy
- Pediatric Surgery
Background:
- Esophageal stenosis (ES) in children presents as a fixed intrinsic narrowing of the esophagus.
- Numerous etiologies contribute to the development of pediatric esophageal strictures.
Purpose of the Study:
- To evaluate the clinical and nutritional impacts of endoscopic balloon dilation (EBD) in Iranian children diagnosed with esophageal stricture.
- To assess the efficacy and safety of EBD as a treatment modality for pediatric esophageal stenosis.
Main Methods:
- Retrospective analysis of pediatric patients (<18 years) undergoing EBD for esophageal stricture from April 2015 to March 2020.
- Evaluation of outcome parameters including dilation frequency, nutritional status (weight-for-age z-score), complications, and clinical success rates.
- Radiologic evidence of esophageal stenosis was required for EBD; clinical success defined as no EBD needed for ≥1 year or <4 dilations/year.
Main Results:
- 53 children (mean age 4.72 years) were included; 331 EBD sessions performed (avg. 6.24/patient).
- Clinical success rate was 62.3% (33/53); one perforation and one mediastinitis occurred, with no mortality.
- Significant improvement in mean weight-for-age z-score was observed post-EBD (from -2.78 to -1.18).
Conclusions:
- Endoscopic balloon dilation (EBD) demonstrates a good clinical success rate for treating esophageal strictures in pediatric patients.
- EBD significantly improves the nutritional status of children suffering from esophageal strictures.
- EBD is a safe and effective therapeutic option for pediatric esophageal stenosis, leading to improved clinical and nutritional outcomes.
Background:
Esophageal stenosis (ES) in children is a fixed intrinsic narrowing of the esophagus due to numerous aetiologies.
Objective:
This study aimed to determine the clinical and nutritional impacts of endoscopic balloon dilation (EBD) in Iranian children with an esophageal stricture.
Methods:
This retrospective study, pediatric patients (aged <18 years) who underwent EBD for esophageal stricture from April 2015 until March 2020 in Abuzar Children's Hospital (Ahvaz, Iran) were enrolled in the study. Outcome parameters were the frequency of dilations, nutritional status, complications, and clinical success rates. EBD was used in children with radiologic evidence of esophageal stenosis. The nutritional status was evaluated by weight-for-age (z-score). Clinical success was considered as no necessity of EBD for a minimum of one year and/or increasing interval among dilation and the frequency of EBD was less than four times per year.
Results:
A total of 53 cases (mean age, 4.72±3.38 years) were enrolled. There were 25 (47.2%) females and 28 (52.8%) males. During follow-up, a total of 331 EBD sessions were performed, with an average of 6.24 sessions per patient. There was one case of perforation and one case of mediastinitis, while there was no other complication or mortality. The clinical success rate of EBD therapy was 62.3% (33/53). The mean standard deviation z-score weight-for-age of patients before and after endoscopic dilation was 2.78 (2.41) and 1.18 (1.87), respectively. The t-test showed a significant difference between the weights-for-age (z-score) before and after endoscopic dilation. The majority of the patients had raised weight-for-age (z-score) after EBD treatment.
Conclusion:
EBD attained a good clinical success rate and nutritional improvement in children with an esophageal stricture.
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