Retrospective analysis of endoscopic dilatation for pediatric patients with esophageal stricture: Bangladesh perspective

Abstract

Background and objectives: Esophageal stricture in children is an intrinsic narrowing of the esophagus due to different etiologies, including congenital anomalies, corrosive substance or foreign body ingestion, and post-esophageal surgeries. The purpose of this study is to retrospectively evaluate the results and procedures of endoscopic dilatation (ED) performed on children with esophageal strictures in a specialized center in Bangladesh. Methods: Between September 2018 and October 2022, 21 children aged 0.2 to 15 years at the time of the first procedure who underwent 48 ED sessions were included at Bangladesh Specialized Hospital (Dhaka, Bangladesh). We documented the basic characteristics of patients, indications for ED, therapeutic procedures, and outcomes. Outcome parameters were the frequency of dilatations, complications (if any), and clinical success rates. Clinical success was defined as no necessity of ED for a minimum of one year or increasing intervals among repeated dilatations. Results: Among the studied patients, the most common causes of stricture were congenital esophageal atresia and ingestion of corrosive substances. More than half of the studied patients required multiple ED sessions, with one patient requiring eight sessions who had congenital esophageal atresia with a postsurgical stricture. Dilatation was achieved mostly using Savary-Gilliard or controlled radial expansion balloons varying in sizes between 8.0 mm to 30 mm. More than 76% of the studied patients had clinical success, while the rest had clinical failures or unfinished treatment. Conclusion: ED attained good clinical success if performed by skilled gastroenterologists. However, repeated dilatation is frequent, especially in patients with a corrosive-caused stricture.