[Balloon dilatation of postoperative esophageal stenoses in children]

T Nordshus1, A Borthne, K O Viddal

  • 1Seksjon for barneradiologi, Ullevål sykehus, Oslo.

Insights

Fluoroscopically guided balloon dilatation is a safe and effective outpatient treatment for esophageal strictures in infants following surgery for esophageal atresia. This minimally invasive approach achieved high success rates with few complications.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Interventional Radiology

Background:

  • Esophageal strictures are a known complication following surgical repair of esophageal atresia.
  • Traditional management often involves repeated dilatations, sometimes requiring anesthesia.
  • Minimally invasive techniques are sought to improve patient outcomes and reduce healthcare burden.

Purpose of the Study:

  • To evaluate the safety and efficacy of fluoroscopically guided balloon dilatation for treating post-operative esophageal strictures in infants.
  • To assess the feasibility of performing these dilatations as an outpatient procedure without sedation or anesthesia.

Main Methods:

  • A retrospective review of seven pediatric patients (under one year of age) treated between 1987-1992.
  • Patients underwent a total of 47 fluoroscopically guided balloon dilatations for esophageal strictures post-esophageal atresia repair.
  • Procedures were performed without the use of sedation or general anesthesia.

Main Results:

  • Six out of seven patients (85.7%) achieved successful treatment of their esophageal strictures.
  • A total of 47 dilatation sessions were performed.
  • Minor complications included one episode of transient cyanosis with respiratory arrest and two intramural tears, none requiring surgical intervention.

Conclusions:

  • Fluoroscopically guided balloon dilatation is a safe and effective treatment modality for esophageal strictures in infants following esophageal atresia repair.
  • The procedure can be successfully performed in an outpatient setting without the need for sedation or anesthesia.
  • This technique offers a minimally invasive option with a high success rate and a low incidence of serious complications.

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