Abstract
To share our institutional experience of placing individually designed fully covered self-expandable metal stents (FCSEMSs) for the treatment of refractory benign esophageal strictures (RBESs) in pediatric patients. A 10-year retrospective study between May 2009 and July 2020 that includes 14 children with RBESs who were treated with individually designed FCSEMSs. Patients were followed-up regularly after stent placement to observe the improvement of vomiting and dysphagia, changes in stenosis diameter and complications. A total of 20 stents were successfully placed in 14 patients. During a follow-up period ranging from 5 to 83 months, except for one 4-year-old child who could not endure chest pain, the remaining 13 patients all benefited from stenting. Their Ogilvie & Atkinson scores improved from grade III–IV to grade 0-I, and the diameters of the stenosis’ were enlarged from 2–5 mm to 9–14 mm. Two patients developed restenosis and granulation tissue hyperplasia was found in 2 patients and stent migration and malapposition in 2 patients with esophageal perforations that required further endoscopic intervention. The use of FCSEMS for RBES is safe and effective in selected pediatric patients. Rationally designed stents and timely management of postoperative complications are critical to ensure the success of this new method.
Highlights
To share our institutional experience of placing individually designed fully covered self-expandable metal stents (FCSEMSs) for the treatment of refractory benign esophageal strictures (RBESs) in pediatric patients
The number of cases of children with RBES treated with stents is relatively s mall[12], so this retrospective study was designed to analyze the clinical data of pediatric patients with RBESs who were treated with FCSEMS in our hospital from May 2009 to July 2020, with the aim of exploring the clinical feasibility of FCSEMS for treating pediatric RBES
This retrospective study enrolled pediatric patients with the following inclusion criteria: (1) Benign esophageal stricture diagnosed on clinical presentation using upper gastrointestinal tract radiography, computerized tomography (CT) or gastroscopy; (2) Dysphagia symptoms did not improve significantly or the stenosis recurred within a short period after ≥ 3 sessions of balloon dilatation; (3) The severity of dysphagia was graded to be III to IV by following Ogilvie & Atkinson s cores[13,14]; (4) Patients were < 18 years old
Summary
To share our institutional experience of placing individually designed fully covered self-expandable metal stents (FCSEMSs) for the treatment of refractory benign esophageal strictures (RBESs) in pediatric patients. A 10-year retrospective study between May 2009 and July 2020 that includes 14 children with RBESs who were treated with individually designed FCSEMSs. Patients were followed-up regularly after stent placement to observe the improvement of vomiting and dysphagia, changes in stenosis diameter and complications. The restoring and elastic force produced by the stent at body temperature produces a long-lasting effect on stenosis of the esophagus, which can expand and keep the esophagus unobstructed Since this expansion process is gradual, the patient can adapt to it, and the tear of the esophageal mucosa occurs in a deliberate fashion, which effectively reduces the risk of bleeding and perforation. The number of cases of children with RBES treated with stents is relatively s mall[12], so this retrospective study was designed to analyze the clinical data of pediatric patients with RBESs who were treated with FCSEMS in our hospital from May 2009 to July 2020, with the aim of exploring the clinical feasibility of FCSEMS for treating pediatric RBES
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