An improved method for retaining retrieval line in children undergoing repeated esophageal dilatation

Children undergoing repeated retrograde esophageal dilatation using gastrostomy introduced Tucker dilators must retain a retrieval line between dilations. Generally, the line is tied into a loop coursing through the esophageal lumen and exits at the gastrostomy and nose. This technique, while effective in maintaining the line in situ, is fraught with hazards of chronic erosion at both exits sites, with significant cosmetic deformity, necessitated by the taped external line and, in the pediatric age group, with frequent harassment by peers and siblings pulling the exposed line. We have modified this technique, leaving the line looped around the nasal septum with both ends extending down the esophagus into the stomach where they are tied to the tip of the gastrostomy catheter. This results in an almost completely internalized line that is protected, well tolerated, and easily retrieved for subsequent use with the dilators.