ESOPHAGEAL STRICTURES FOLLOWING ESOPHAGEAL ATRESIA REPAIR IN CHILDREN IN SULAIMANI CITY; FREQUENCY AND RESPONSE TO ENDOSCOPIC BALLOON DILATATION
DOI:
https://doi.org/10.17656/jsmc.10245Keywords:
Esophageal atresia, Esophageal dilatation, Anastomotic StrictureAbstract
Background
Anastomotic stricture is the main complication after surgical repair of esophageal atresia and balloon dilatations remain the treatment of choice for symptomatic esophageal strictures.
Objectives
The aim of this study was to evaluate the frequency of anastomotic stricture and the efficacy and complications of esophageal balloon dilatations for symptomatic anastomotic stricture in children with esophageal atresia treated in our center.
Patients and Methods
The medical records of 28 children operated on for esophageal atresia type C (Gross) over a 6-year period were retrospectively reviewed.
Results
Anastomotic stricture developed in 6 (21.4%) of the patients. They were submitted to 17 dilatation sessions. Stricture resolution occurred after a mean dilatation of 2.83 per patient (range, 1-7). Dilation was successful in 100% of patients. No complications were happened during or after the dilatation sessions.
Conclusions
Anastomotic stricture, secondary to the surgical treatment of esophageal atresia, is a common complication in patients with esophageal atresia. Esophageal dilation with balloon dilators is an effective and very safe procedure in the management of strictures.
References
Spitz L. Esophageal atresia. Orphanet J Rare Dis 2007; 2: 24 DOI: https://doi.org/10.1186/1750-1172-2-24
Thomas Kovesi and Steven Rubin. Long-term Complications of Congenital Esophageal Atresia and/or Tracheoesophageal Fistula. Chest 2004;126;915-925 DOI: https://doi.org/10.1378/chest.126.3.915
Choudhry M, Boyd PA, Chamberlain PF, Lakhoo K. Prenatal diagnosis of tracheo-oesophageal fistula and esophageal atresia. Prenat Diagn 2007; 27:608–10. DOI: https://doi.org/10.1002/pd.1745
Van der Zee DC. Thoracoscopic elongation of the esophagus in long-gap esophageal atresia. J Pediatr Gastroenterol Nutr 2011; 52 Suppl 1:S13 DOI: https://doi.org/10.1097/MPG.0b013e3182125d75
Spitz L. Esophageal atresia. Lessons I have learned in a 40-year experience. J Pediatr Surg 2006; 41: 1635-1640 DOI: https://doi.org/10.1016/j.jpedsurg.2006.07.004
De Lagausie P. GER in oesophageal atresia: surgical options. J Pediatr Gastroenterol Nutr 2011; 52 Suppl 1:S27. DOI: https://doi.org/10.1097/MPG.0b013e3182133155
Yanchar NL, Gordon R, Cooper M, et al. Significance of the clinical course and early upper gastrointestinal studies in predicting complications associated with repair of esophageal atresia. J Pediatr Surg 2001; 36:815 DOI: https://doi.org/10.1053/jpsu.2001.22969
PD Siersema. Treatment option for esophageal strictures.gasthep 2008;5(3): 142-152. DOI: https://doi.org/10.1038/ncpgasthep1053
Mortell AE, Azizkhan RG. Esophageal atresia repair with thoracotomy: the Cincinnati contemporary experience. Semin Pediatr Surg 2009; 18: 12-19 DOI: https://doi.org/10.1053/j.sempedsurg.2008.10.003
Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy.Esophageal dilatation guidline.Gastrointestinal endoscopy. 2006; 63(6):755-760
Bergmeijer JH, Hazebroek FWJ. Prospective medical and surgical treatment of gastroesophageal reflux in esophageal atresia. J Am Coll Surg 1998;187:153-7. DOI: https://doi.org/10.1016/S1072-7515(98)00116-1
Michaud L, Guimber D, Sfeir R, et al. Anastomotic stenosis after surgical treatment of esophageal atresia: frequency, risk factors and effectiveness of esophageal dilatations. Arch Pediatr 2001; 8:268-74. DOI: https://doi.org/10.1016/S0929-693X(00)00193-7
Kim IO, Yeon KM, Kim WS, et al. Perforation complicating balloon dilation of esophageal strictures in infants and children. Radiology 1993;189:741-4. DOI: https://doi.org/10.1148/radiology.189.3.8234699
Khalid M. Khan.Endoscopic management of strictures in pediatrics. Techniques in Gastrointestinal Endoscopy 2013; 15(1):25–31. DOI: https://doi.org/10.1016/j.tgie.2012.10.002
McLean GK, LeVeen RF. Shear stress in the performance of esophageal dilation: comparison of balloon dilation and bougienage. Radiology 1989; 172:983. DOI: https://doi.org/10.1148/172.3.983
Wesdorp IC, Bartelsman JF, den Hartog Jager FC, et al. Results of conservative treatment of benign esophageal strictures: a follow-up study in 100 patients. Gastroenterology 1982; 82:487. DOI: https://doi.org/10.1016/S0016-5085(82)80397-1
Olle Ekberg, Anders Borgström, Frans-Thomas Fork, and Eje Lövdahl. Endoscopic Balloon Dilatation of Benign Esophageal Stricture—A Nonhazardous Procedure?. Diagn Ther Endosc. 1994; 1(2): 93–97. DOI: https://doi.org/10.1155/DTE.1.93
Adnan MH. Hamawandi, Taha A. Karboli, Aras A.Abdulla, Azad J. Ali. Endoscopic dilatation of esophageal stricture in children: causes and outcome in 47 patients. Duhok Med J 2010;4(2):30-38.
Thyoka M, Barnacle A, Chippington S, et al. Fluoroscopic balloon dilation of esophageal atresia anastomotic strictures in children and young adults: single-center study of 103 consecutive patients from 1999 to 2011. Radiology. 2014 May;271(2):596-601 DOI: https://doi.org/10.1148/radiol.13122184
Lang T, Hummer HP, Behrens R. Balloon dilation is preferable to bougienage in children with esophageal atresia. Endoscopy 2001;33 (4):329-335. DOI: https://doi.org/10.1055/s-2001-13691
Downloads
Published
Issue
Section
License
Copyright (c) 2020 Adnan Mohammed Hasan, Mahdi Aziz Hama Marif, and Rozhan Nabaz M. Sediq
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This work is licensed under 