Is balloon dilatation enough for treating congenital esophageal stenosis (CES) in pediatric patients? | 15 years | Retrospective review of patients diagnosed and treated for CES at single institution | 19 patients | confirmed with radiologic & endoscopic investigations | Complete symptom resolution: 14 patients | median of 5 recurrent balloon dilatations for 7.5 months | 2 patients had mild dysphagia not interfering w/ daily living | 3 patients underwent surgery | Median of 48 months of follow-up | 17 patients → symptom-free | Conclusion: Conservative treatment with esophageal balloon dilatations is an efficient and reliable modality that can be used as a first-line treatment in CES. | https://pubmed.ncbi.nlm.nih.gov/34229876/ | Source: Kılıç ŞS et al. Department of Pediatric Surgery, Faculty of Medicine, Çukurova University, Adana, Turkey | @EmTombash | @StayCurrentMD | Cincinnati Children's | Journal of Pediatric Surgery
Management and clinical outcomes of congenital esophageal stenosis in pediatric patients: Experience of a tertiary referral center
Infographic · May 2022 · 1 min read
In brief
In brief
This retrospective study of 19 pediatric patients with congenital esophageal stenosis demonstrates that conservative management with balloon dilatation achieves symptom resolution in 89% of cases, requiring a median of 5 procedures over 7.5 months. Surgery was reserved for failed dilatation or persistent growth retardation, supporting a step-up treatment approach.
- Conservative esophageal balloon dilatation achieved complete symptom resolution in 74% (14/19) of pediatric CES patients after median 5 sessions.
- Step-up approach: reserve surgery for failed initial dilatation, persistent symptoms, or growth retardation despite ongoing dilatation therapy.
- Long-term success: 89% (17/19) of patients were symptom-free after median 48-month follow-up using this non-aggressive treatment strategy.
- Balloon dilatation is safe and effective as first-line CES treatment, requiring median 7.5 months of repeated sessions for symptom resolution.
Written by the GCMD Library team from the infographic.
A teal and yellow infographic divided into sections with icons including a calendar, bell, and silhouette of a child's esophagus. Colorful illustrations of children appear in the middle section. The layout flows from top to bottom presenting study design, patient outcomes, and conclusions with numerical data highlighted in large text.
Şeref Selçuk Kılıç, Hilmi Serdar İskit
Purpose: This study aimed to retrospectively investigate congenital esophageal stenosis (CES) cases managed at our institution using a non-aggressive strategy based on a step-up approach from esophageal balloon dilatations to surgery.
Methods: Patients' charts with CES managed in a tertiary pediatric surgery department were retrospectively evaluated. Demographic characteristics, clinical features, pH-monitoring, imaging, and esophagoscopy results were recorded together with their treatments and outcomes.
Results: Nineteen patients, confirmed with radiologic and endoscopic investigations, were managed. Complete symptom resolution was achieved in 14 patients by a median of five (2-15) recurrent esophageal balloon dilatations lasting for 7.5 (2-108) months. Two more patients, after 7 and 15 dilatations, had mild dysphagia, not interfering with their daily living. One patient, in whom the initial dilatation attempt with 3 atm was unsuccessful, and two patients with persistent symptoms and growth retardation despite ongoing dilatation treatment, underwent surgery. After 48 (12-132) months of follow-up, 17 patients were symptom-free.
Conclusion: Conservative treatment with esophageal balloon dilatations is an efficient and reliable modality that can be used as a first-line treatment in CES. Surgical treatment option should be used when dilatation attempt is unsuccessful, or symptoms and growth retardation persist despite dilatation treatment.