A functional study of caustic strictures of the esophagus in children

Da-Costa-Pinto, Elizete Aparecida Lomazi; Dorsa, Tatiana Kores; Altimani, A.; Andreollo, Nelson Adami; Cardoso, Sílvia Helena; Morais, Drausio Jefferson; Bustorff‐Silva, Joaquim Murray

doi:10.1590/s0100-879x2004001100005

Cited by 13 publications

(6 citation statements)

References 17 publications

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“…In our study, 8% (6/75) of patients had an esophageal fistula, and the incidence was higher in caustic strictures patients (4/6). Caustic esophageal stenosis, with deep and wide esophageal lesions involving the whole esophageal wall, had a greater association with surgery, compared to repeated dilations, which may have low security and high risk of esophageal fistula [23]. The mean length of stenting was 29 days.…”

Section: Discussionmentioning

confidence: 99%

The role of endoscopic dilation and stents in refractory benign esophageal strictures: a retrospective analysis

et al. 2019

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Background The outcomes of patients with refractory benign esophageal strictures (RBES) are unclear, and the clinical efficacy of dilation versus stent placement is lacking. Our objective was to explore the role of endoscopic dilation and stents placement in the management of RBES. Methods RBES patients treated with dilation and stents in our hospital between January 2009 and December 2017 were included in this study. The primary outcomes were to assess clinical effectiveness and adverse events. The secondary outcome was to identify factors that predicted the dysphagia-free period. Results Among 75 RBES patients (54 male; median age 59 years), 39 (52%), 20 (26.7%), 3 (4%), 10 (13.3%), and 3 (4%), were postsurgical, post-ESD, achalasia of cardia, caustic and mixed etiology, respectively. The median number of endoscopic therapy was 5 times (range 3, 21). Endoscopic therapy was successful in 46 patients (61.3%). Patients treated with dilation showed a higher success rate (70.9%, 39/55) than that treated with stents (35%, 7/20). Fifteen patients died during follow-up. Nineteen patients had adverse events after endoscopic therapy. In total, the mean dysphagia-free period was 3.4 months (95% CI, 2.5–4.3). The patients treated with dilation demonstrated a dysphagia-free period of 3.7 months (95% CI, 2.7–5), while patients treated with stents displayed a dysphagia-free period of 2.3 months (95% CI, 1.5–3). The dysphagia-free period had a linear growth trend over time, with an increase of 12 days per endoscopic therapy. Conclusion The dysphagia-free period increased by 12 days per endoscopic therapy, so the endoscopic therapy tended to be effective in patients with RBES by increasing the dysphagia-free period. However, compared to dilation therapy, stent therapy was not effective in increasing the dysphasia-free period and reducing the times and frequency of dilation. In addition, univariate and multivariate analyses also indicated that etiology may predict the endoscopic therapy outcome. Trial registration This study was retrospectively registered and approved by the Ethics Committee of West China Hospital of Sichuan University (IRB number: ChiCTR1800016321 ).

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Section: Discussionmentioning

confidence: 99%

The role of endoscopic dilation and stents in refractory benign esophageal strictures: a retrospective analysis

et al. 2019

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“…Da-Costa-Pinto et al (5) suggested that GER is due to both shortening of oesophageal length in the vertical plane because of fibrosis and motility disorder secondary to corrosive substance injury in patients with CES. An objective diagnostic method showing shortening of oesophageal length could not be defined.…”

Section: Discussionmentioning

confidence: 99%

“…An objective diagnostic method showing shortening of oesophageal length could not be defined. In patients experiencing oesophageal replacement and oesophagectomy because of CES, extensive fibrosis is mainly observed in mucosal, submucosal and inner muscular layers in histopathological examinations (5).…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting the Prevalence of Gastro-oesophageal Reflux in Childhood Corrosive Oesophageal Strictures

Iskit¹,

Özçelik²,

Alkan³

et al. 2014

Balkan Med J

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Oesophageal stricture is the most common complication of corrosive ingestion in childhood and standard dilatation treatment has a success rate of approximately 50-70% (1-3). Clinical studies conducted on the achievement of dilatation treatment emphasise the effects of the following parameters: start of dilatation treatment, stricture length, largest dilatator diameter used in the dilatation program and development of any perforations during the dilatation process (4). With the exception of corrosive substance ingestion, negative effects of gastro-oesophageal reflux (GER) on other causes of oesophageal strictures are clearly known. Previous studies published in English have not discussed the details of the relationship between stricture formation and GER, nor the risk factors which cause the development of GER in patients suffering from oesophageal stricture due to corrosive substance ingestion (5-9). The aim of this clinical study is to investigate the relating factors affecting the prevalence of GER and the effects of GER on the treatment of patients suffering from oesophageal stricture due to corrosive substance ingestion. MATERIAL AND METHODSÇukurova University Ethics Committee approved the study and written informed consent forms were signed by families of the parBackground: Gastro-oesophageal reflux may accompany the corrosive oesophageal damage caused by the ingestion of corrosive substances and affect its treatment. The factors that affect the development of reflux in these cases and their effects on treatment still remain unclear. Aims: Our aim is to investigate the prevalence of gastro-oesophageal reflux in children with corrosive oesophageal strictures, the risk factors affecting this prevalence and the effects of gastro-oesophageal reflux on treatment. Study Design: Case-control study. Methods: We enrolled 52 patients with oesophageal stricture due to corrosive substance ingestion who were referred to our clinic between 2003 and 2010. Groups, which were determined according to the presence of gastro-oesophageal reflux (GER), were compared with each other in terms of clinical findings, results of examination methods, characteristics of the stricture and success of the treatment. Results: The total number of patients in our study was 52; 30 of them were male and 22 of them were female. The mean age of our study population was 4.2±2.88 years. Thirty-three patients had gastrooesophageal reflux (63.5%). Patients who had strictures caused by the ingestion of alkali substances were 1.6-times more likely to have reflux. There were no differences between patients with or without reflux in terms of number and localisation of strictures. Mean distance of stricture was longer in patients with reflux (3.7±1.8 cm) than in patients without (2.2±1.0 cm) (p<0.005). Only one patient among 17 who had a long stricture (≥4 cm) did not suffer from reflux. Patients with long stricture were 1.9-times more likely to have reflux. Dilatation treatment was successful in 69.6% of patients with reflux and in 78.9% of patients with...

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“…In such patients with distal impassable strictures of the thoracic esophagus in addition to a cricopharyngeal stricture, we previously described an inlay pectoralis major myocutaneous flap, which opens access to the cervical esophagus, permitting an esophagocolic anastomosis as a second stage distal to the reconstructed cricopharynx. An anastomosis at this level provides acceptable swallowing ability without aspiration [4].…”

Section: Discussionmentioning

confidence: 99%

Sternocleidomastoid Muscle Myocutaneous Flap for Corrosive Pharyngoesophageal Strictures

et al. 2007

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A functional study of caustic strictures of the esophagus in children

Cited by 13 publications

References 17 publications

The role of endoscopic dilation and stents in refractory benign esophageal strictures: a retrospective analysis

The role of endoscopic dilation and stents in refractory benign esophageal strictures: a retrospective analysis

Factors Affecting the Prevalence of Gastro-oesophageal Reflux in Childhood Corrosive Oesophageal Strictures

Sternocleidomastoid Muscle Myocutaneous Flap for Corrosive Pharyngoesophageal Strictures

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