Efficacy of Endoscopic Balloon Dilation in Iranian Pediatric Patients With Esophageal Stricture

Abstract

BACKGROUND: Esophageal stenosis (ES) in children is a fixed intrinsic narrowing of the esophagus due to numerous aetiologies. OBJECTIVE: This study aimed to determine the clinical and nutritional impacts of endoscopic balloon dilation (EBD) in Iranian children with an esophageal stricture. METHODS: This retrospective study, pediatric patients (aged <18 years) who underwent EBD for esophageal stricture from April 2015 until March 2020 in Abuzar Children’s Hospital (Ahvaz, Iran) were enrolled in the study. Outcome parameters were the frequency of dilations, nutritional status, complications, and clinical success rates. EBD was used in children with radiologic evidence of esophageal stenosis. The nutritional status was evaluated by weight-for-age (z-score). Clinical success was considered as no necessity of EBD for a minimum of one year and/or increasing interval among dilation and the frequency of EBD was less than four times per year. RESULTS: A total of 53 cases (mean age, 4.72±3.38 years) were enrolled. There were 25 (47.2%) females and 28 (52.8%) males. During follow-up, a total of 331 EBD sessions were performed, with an average of 6.24 sessions per patient. There was one case of perforation and one case of mediastinitis, while there was no other complication or mortality. The clinical success rate of EBD therapy was 62.3% (33/53). The mean standard deviation z-score weight-for-age of patients before and after endoscopic dilation was 2.78 (2.41) and 1.18 (1.87), respectively. The t-test showed a significant difference between the weights-for-age (z-score) before and after endoscopic dilation. The majority of the patients had raised weight-for-age (z-score) after EBD treatment. CONCLUSION: EBD attained a good clinical success rate and nutritional improvement in children with an esophageal stricture.

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

“…In our study, about 47% of patients had symptom relief after their first ED session, comparable to the rates achieved by others. [7,14] The rest, 52.4%, had multiple sessions. We observed that a median of 2 sessions was required for patients with multiple ED.…”

Electrocautery Incisional Therapy for Refractory Anastomotic Stricture in a Child: Report from Ahvaz, Iran

“…1 Several methods including balloon dilation and Savary dilator were used more frequently in the treatment of esophageal stenosis. 2,3 Endoscopic electrocautery incisional therapy (EIT) is the method that is recommended for refractory esophageal stricture especially anastomotic stricture. We discuss the first report of endoscopic electrocautery surgery for the child with refractory anastomotic stricture.…”