Abstract

Objective: To evaluate the effectiveness and safety of fluoroscopic balloon dilatation (FBD) in infants and children with esophageal benign stricture. Methods: The medical records of 53 children (14 cases with corrosive esophagostenosis and 39 cases with anastomotic stricture following repair of esophageal atresia) diagnosed with esophageal stricture and required FBD therapy from July 2007 to December 2015 in our hospital were retrospectively reviewed. All procedures for balloon catheter dilation treatments were performed under general anesthesia using fluoroscopic guidance. The dilation effects during operation were compared. The clinical effectiveness was analyzed during the 6-18 months post-operation follow-up. Results: A total of 187 FBD sessions (median, 3.5 dilations per patient; range, 1-11 dilations) were performed in 53 patients. The balloon catheter diameters ranged from 6 to 20 mm. Patients with corrosive esophagostenosis required two or more dilations, all 14 patients (100%) were successfully dilated. Eleven out of 39 (28.2%) patients with anastomotic stricture were successfully dilated for one dilation, and the rest (71.8%) were successfully dilated for two or more dilations. There was no statistical difference in the times of dilation between the two groups (P>0.05) . The X-ray barium meal contrast examination showed an obvious expansion of esophageal stricture after operation, and the contrast agent successfully passed through the narrow location. The outcome of treatment reached the curative criterion and the success rate of balloon dilatation was 100%. During the 6-18 months follow-up, the total effective rate of FBD treatment was 79.2% (42/53) . The effective rate of patients with anastomotic stricture (87.1%, 34/39) was significantly higher than patients with corrosive esophagostenosis (57.1%, 8/14) . There was statistical difference in effective rate between the two groups (χ2=3.972, P<0.05) . Conclusions: Fluoroscopically guided esophageal balloon dilatation with remarkable curative effect could be considered to be the first option for management of esophageal benign stricture, especially for anastomotic stricture following repair of esophageal atresia. The treatment is safe and easy for operating, and is worth of clinical application and popularizing. Key words: Esophageal benign stricture; Balloon dilatation; Infants and children

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