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Long-term outcomes of balloon dilation of esophageal strictures in children
J Lisý1, M Hetková, J Snajdauf
1Clinic for Imaging Methods, University Hospital Motol, Charles University, Prague, Czech Republic.
Insights
Balloon dilation is a successful long-term treatment for pediatric esophageal strictures, particularly those resulting from surgery or reflux. This minimally invasive approach offers significant relief from dysphagia in many young patients.
Area of Science:
- Pediatric Gastroenterology
- Interventional Endoscopy
- Pediatric Surgery
Background:
- Esophageal strictures in children can cause significant dysphagia.
- Treatment options for pediatric esophageal strictures are varied.
- Long-term efficacy of balloon dilation for pediatric esophageal strictures requires further evaluation.
Observation:
- This study evaluated 24 children with esophageal strictures treated with fluoroscopically guided balloon dilation.
- Stricture etiologies included post-surgical repair of esophageal atresia, achalasia, gastroesophageal reflux, corrosive ingestion, congenital stenosis, and radiation therapy.
- Success was defined as the resolution of dysphagia one year after the final dilation procedure.
Findings:
- Overall, 15 out of 24 children (62.5%) achieved successful outcomes, with no dysphagia one year post-dilation.
- The highest success rates were observed in children with strictures secondary to surgical repair of esophageal atresia and those caused by gastroesophageal reflux.
- Dilation showed less efficacy in treating strictures from other causes such as achalasia, corrosive injuries, congenital stenosis, and radiation therapy.
Implications:
- Fluoroscopically guided balloon dilation is a highly effective treatment for specific pediatric esophageal strictures, notably post-surgical and reflux-related.
- This minimally invasive technique offers a valuable therapeutic option for improving swallowing function in children.
- Further research may refine patient selection criteria to optimize outcomes for less responsive stricture etiologies.
Rationale And Objectives:
The purpose of this study was to determine the long-term success of the use of angioplasty balloons for dilation of esophageal strictures in children.
Materials And Methods:
The authors studied 24 children who had undergone fluoroscopically guided angioplasty balloon dilation of esophageal strictures. Ten children had stricture of the anastomosis after surgical repair of esophageal atresia; five had achalasia; three had strictures due to gastroesophageal reflux; three had corrosive strictures; two had congenital stenosis; and one had stricture after radiation therapy. Success was defined as resolution of the dysphagia a year after dilation.
Results:
A year after the last dilation, 15 of the 24 children had no dysphagia. Patients in whom treatment was successful included eight children with strictures after surgery for esophageal atresia, one with achalasia, three with strictures caused by gastroesophageal reflux, one with a corrosive stricture, one with congenital stenosis, and one with a stricture resulting from radiation therapy.
Conclusion:
The long-term results of balloon catheter dilation are highly successful in patients with stricture after surgical repair of esophageal atresia and stricture due to gastroesophageal reflux. Dilation is not as valuable in the treatment of esophageal strictures resulting from other causes.