Balloon dilatation for congenital esophageal stenosis associated with esophageal atresia
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In brief
In brief
This retrospective study examines treatment outcomes for congenital esophageal stenosis in patients with esophageal atresia, found in 23% of EA cases. Balloon dilatation achieved 89% success despite requiring multiple procedures and a 56% perforation rate, with all complications managed conservatively.
- 23% of esophageal atresia patients have congenital esophageal stenosis, a higher prevalence than previously recognized.
- Balloon dilatation achieved 89% success rate for EA-associated CES, though requiring more sessions than anastomotic stricture (median 5 vs fewer).
- Perforation occurred in 56% of CES dilatations but all were managed conservatively without surgical intervention.
- EA-associated CES requires more dilatation sessions than postoperative anastomotic stricture alone (p=0.012).
- Endoscopic balloon dilatation is effective first-line treatment for EA-associated CES, with surgical resection rarely needed.
Written by the GCMD Library team from the article.
Abstract
Purpose
Congenital esophageal stenosis (CES) associated with esophageal atresia (EA) is rare, and no standard treatment has been established. We reviewed cases of EA-associated CES to assess the clinical characteristics and treatment outcomes, especially the feasibility of endoscopic dilatation.
Methods
We retrospectively examined patients with EA-associated CES. We also compared treatment outcomes of EA-associated CES with those of EA patients without CES who developed postoperative anastomotic stricture.
Results
Among 44 patients with EA, ten had CES (23%). Postoperative complications were not significantly different between EA patients with CES and those without CES but with anastomotic stricture. All CES patients underwent balloon dilatation as initial treatment. Eight of nine patients (89%) were successfully treated by dilatation only, and one patient underwent surgical resection. The median number of balloon dilatations for CES was five (2–17), which was higher than that for anastomotic stricture in patients without CES (p = 0.012). Esophageal perforation occurred in five patients with CES (5/9, 56%) after dilatation, but all perforations were successfully managed conservatively with an uneventful post-dilatation course.
Conclusions
Twenty-three percent of patients with EA had CES. Although balloon dilatation for EA-associated CES required multiple treatments and carried a risk of perforation, balloon dilatation showed an 89% success rate and all perforations could be managed conservatively.