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[Treatment of short esophageal stricture in children]
Insights
This study defines short esophageal strictures and evaluates intraesophageal compression, achieving an 86% success rate. Esophageal NMR tomography is recommended for treatment selection in pediatric patients.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Medical Imaging
Background:
- Short esophageal strictures (1.5-2.0 cm) require distinct classification.
- Understanding their formation and clinical presentation is crucial for effective management.
- Transesophageal treatment methods offer a promising therapeutic avenue.
Purpose of the Study:
- To establish a nosological entity for short esophageal strictures.
- To evaluate the efficacy of intraesophageal compression for treating these strictures.
- To determine objective criteria for selecting appropriate treatment modalities.
Main Methods:
- Analysis of intraesophageal compression using two device types in 64 pediatric patients.
- Surgical interventions including esophageal resection and anastomosis, and colonic esophagoplasty for non-responders.
- Recommendation of esophageal NMR tomography for treatment indication objectification.
Main Results:
- A positive outcome was achieved in 86% of patients treated with intraesophageal compression.
- Surgical interventions were performed on the remaining patients with no recorded mortality.
- Esophageal NMR tomography is proposed to guide treatment decisions.
Conclusions:
- Intraesophageal compression is an effective treatment for short esophageal strictures in children.
- A structured approach combining non-surgical and surgical methods, guided by imaging, improves outcomes.
- Further research into esophageal NMR tomography's role in treatment selection is warranted.
Abstract:
The authors find it necessary to identify a nosological entity of short esophageal strictures, up to 1.5-2.0 cm long, from the specific features of their formation, clinical manifestations and from the possibility of widely using transesophageal methods of treatment. Among them, a procedure for intraesophageal compression of the scarring ring by using two types of devices in 64 patients was analysed. There was a positive result in 86% of the patients. The remaining children underwent surgical interventions: resection of an esophageal portion with esophagus-esophagus anastomosis and colesophagoplasty. No deaths were recorded. To objectivize the indications for either method of treatment, the authors recommend esophageal NMR tomography.