Comparison between Balloon & Savary Dilatation in Management of Benign Esophageal Strictures in Pediatrics

A few comments about benign esophageal strictures

Adverse events of upper GI endoscopy

Response

Endoscopic Management of the Difficult Benign Esophageal Stricture

Enteral stents: from esophagus to colon

Adverse events associated with EGD and EGD-related techniques

Endocarditis prophylaxis for esophageal dilation: A confusing issue?

Managing oesophageal strictures, whether benign or malignant has always been a challenging task for ENT Surgeons, Endoscopists, Cardio-thoracic surgeons and Gastro-enterologists. Although various newer technological developments have helped in better management of malignant strictures, it is the benign strictures that are still being managed by conventional means with gum-elastic bougies and other dilatation techniques. Children are not immune to benign strictures, rather corrosive strictures, congenital webs and membranes etc. are much more common in the paediatric age group. We present the technical details and our experience in managing benign oesophageal strictures in five children by endoscopic balloon dilatation.

The role of endoscopy in the evaluation and management of dysphagia

Balloon Catheter Dilatation of Benign Esophageal Strictures in Children

The esophageal stricture is an important clinical problem in children, and the treatment is difficult. To evaluate the results of fluoroscopy-guided balloon dilatation of benign pediatric esophageal strictures and to suggest a safety range for balloon diameters. We retrospectively reviewed the medical records of children who underwent fluoroscopy-guided esophageal balloon dilatation for treatment of benign esophageal stricture from February 2008 to July 2019. We recorded the demographic data of the children, technical details of each procedure, balloon diameter, number of repeated procedures, clinical and technical success rates, complications and follow-up period. Technical success was defined as the disappearance of the waist formation on the balloon catheter, and clinical success was defined as no need for re-dilation or other treatment methods during the 1-year follow-up after the procedure. These children were divided into groups and evaluated according to esophageal stricture etiology. Technically successful procedures included 375 balloon dilatations in 116 patients (67 boys; age range: 1month to 18years; mean age: 4.3 ± 4.8 standard deviation [SD] years at the initial dilatation). The follow-up period was 1-138months (median: 41months; mean: 44months) since the last dilatation. In this study, the clinical success rate was 34% per procedure (120 of 353 procedures) and 85% per patients (91 of 107 patients). The total complication rate per procedure was 0.5%, and the perforation rate was 0.25% per session. Fluoroscopy-guided esophageal balloon dilatation is an effective and reliable method for treating benign esophageal strictures in children.

The Use of Self-Expanding Silicone Stents in Esophagectomy Strictures: Less Cost and More Efficiency

Invited Commentary

Management of a refractory benign esophageal stricture with a new biodegradable stent

Background: Oesophageal stricture is a common problem in general surgical practice. It can be benign or malignant, simple or complex. Benign oesophageal strictures include peptic, corrosive, post-surgical anastomotic strictures, post radiotherapy and drug induced strictures. The aetiology of this condition varies in developed and developing countries. Aim of present study was to determine the aetiology of benign oesophageal stricture, to evaluate the role of endoscopic dilatation of stricture and final outcome in these patients in our region.Methods: This prospective descriptive study was conducted in department of surgery at a tertiary care teaching hospital at Aurangabad from December 2009 to November 2013. All the patients, regardless of age and gender, admitted with diagnosis of benign oesophageal stricture were included in the study. Depending upon the type of stricture treatment was carried out. Postoperatively patients were followed up for detection of possible complications and their treatment.Results: Total 50 patients of oesophageal stricture were studied. Mean age was 33.65 years with male to female ratio 2.8:1. Ingestion of corrosive substance was the commonest etiology noted followed by peptic strictures.Conclusions: Corrosive ingestion was the commonest cause of benign oesophageal stricture in our region followed by peptic strictures. Endoscopic dilatation is safe and effective in treating benign oesophageal strictures.