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[Usefulness of dilatation in esophageal stricture in children]
Z Montilla-González1, P Torres, E Rivero
1Servicio de Gastroenterología, Hospital de Niños J. M. de Los Ríos, Caracas, Venezuela.
Insights
Early esophageal dilation in children significantly improves outcomes for various narrowness causes. This approach reduces the need for surgery, offering a more successful treatment pathway.
Area of Science:
- Pediatric Gastroenterology
- Surgical Pediatrics
Context:
- Esophageal narrowness affects children of various ages.
- Diverse etiologies contribute to pediatric esophageal strictures.
- Long-term management of esophageal strictures in children presents challenges.
Purpose:
- To evaluate the efficacy of periodic dilatations for pediatric esophageal narrowness.
- To determine factors influencing successful dilation treatment outcomes.
- To assess the necessity and types of surgical interventions following dilation therapy.
Summary:
- A study followed 140 children (23 days to 12 years) with esophageal narrowness treated with periodic dilatations.
- Early and timely dilatations were associated with higher success rates, particularly for caustic ingestion and post-surgical strictures.
- Overall, 81.4% of patients achieved successful resolution with dilation, while 14.2% required surgical intervention.
Impact:
- Periodic dilation is an effective primary treatment for pediatric esophageal narrowness.
- Early intervention with dilation can minimize the need for complex surgical procedures.
- This study highlights the importance of tailored dilation protocols based on etiology and patient factors.
Abstract:
During 8 years, 140 children aged from 23 days old to 12 years old with the diagnosis of esophageal narrowness of different etiologies were studied. They had been treated through periodic dilatations according to their needs; the number of dilatations varied in relation to the clinic entity, age and time passed since the beginning of treatment standing out that the precocious dilatations had a greater success as less of them were required, specially in children with esophageal narrowness post ingestion of caustic and those with post surgical narrowness from correction of esophageal atresia. Among the patients who finished the treatment with dilatations, 81.4% were success fully resolved including 14.2% who needed surgical treatment, that is, resection of stenosis in 7.15%, transposition of colon in 4.28%, and required Nissen operation in 2.85% of patients.