Do you always operate on Congenital esophageal stenosis?

Topic overview

Article you should know

"Management and clinical outcomes of congenital esophageal stenosis in pediatric patients: Experience of a tertiary referral center" Şeref Selçuk Kılıç et.al.

Full article: https://www.jpedsurg.org/article/S0022-3468(21)00474-7/fulltext

Authors: Şeref Selçuk Kılıç, Hilmi Serdar İskit

Abstract

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.

Intended audience: Healthcare professionals and clinicians.