Abstract
Surgical repair of oesophageal atresia may result in anastomotic strictures. These strictures are often treated by balloon dilatation (BD) and currently balloon dilatation (fluoroscopic or endoscopic) is the preferred primary treatment method. Here we review the current evidence of the outcomes of balloon dilatation of anastomotic strictures secondary to surgical repair of oesophageal atresia. We searched the standard databases (January, 1960–May, 2012) to identify all studies that reported outcomes of balloon dilatation of anastomotic strictures secondary to surgical repair of oesophageal atresia in children. Data, reported as median (range), were analysed and compared. Outcomes were success of BD, number of BD sessions, number of oesophageal perforations, need for other surgical interventions and mortality. Five studies were found to be relevant (n = 139; 81 [58%] male children). The total number of dilatation sessions was 401 (2.9 dilatations per child patient). General anaesthesia was used in two (40%) studies; sedation in a further two (40%) studies and one (20%) study used a combination of both. The size of balloon catheter ranged from 4 mm to 22 mm. Seven perforations were reported (1.8% per dilatation session), of which only one (14%) required surgery. No deaths were recorded. Balloon dilatation for anastomotic strictures post-EA repair is safe, and associated with a low perforation and mortality rates. Most perforations are amenable to conservative management.
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References
Chittmittrapap S, Spitz L, Kiely EM et al (1990) Anastomotic stricture following repair of esophageal atresia. J Pediatr Surg 25:508–511
Serhal L, Gottrand F, Sfeir R et al (2010) Anastomotic stricture after surgical repair of esophageal atresia: frequency, risk factors, and efficacy of esophageal bougie dilatations. J Pediatr Surg 45:1459–1462
Ko HK, Shin JH, Song HY et al (2006) Balloon dilation of anastomotic strictures secondary to surgical repair of esophageal atresia in a pediatric population: long-term results. J Vasc Interv Radiol 17:1327–1333
London RL, Trotman BW, DiMarino AJ Jr et al (1981) Dilatation of severe esophageal strictures by an inflatable balloon catheter. Gastroenterology 80:173–175
Ball WS, Strife JL, Rosenkrantz J et al (1984) Esophageal strictures in children. Treatment by balloon dilatation. Radiology 150:263–264
Johnsen A, Jensen LI, Mauritzen K (1986) Balloon-dilatation of esophageal strictures in children. Pediatr Radiol 16:388–391
Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097
Said M, Mekki M, Golli M et al (2003) Balloon dilatation of anastomotic strictures secondary to surgical repair of oesophageal atresia. Br J Radiol 76:26–31
Antoniou D, Soutis M, Christopoulos-Geroulanos G (2010) Anastomotic strictures following esophageal atresia repair: a 20-year experience with endoscopic balloon dilatation. J Pediatr Gastroenterol Nutr 51:464–467
Lang T, Hummer HP, Behrens R (2001) Balloon dilation is preferable to bougienage in children with esophageal atresia. Endoscopy 33:329–335
LaBerge JM, Kerlan RK Jr, Pogany AC et al (1985) Esophageal rupture: complication of balloon dilatation. Radiology 157:56
Rivas S, Martinez L, Hernandez F et al (2004) Aggressive conservative treatment remains the best option for oesophageal perforation in children. Cir Pediatr 17:3–7
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Thyoka, M., Timmis, A., Mhango, T. et al. Balloon dilatation of anastomotic strictures secondary to surgical repair of oesophageal atresia: a systematic review. Pediatr Radiol 43, 898–901 (2013). https://doi.org/10.1007/s00247-013-2693-2
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DOI: https://doi.org/10.1007/s00247-013-2693-2