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Efficacy and histopathological esophageal wall damage of biodegradable esophageal stents for treatment of severe refractory esophageal anastomotic stricture in a child with long gap esophageal atresia

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Abstract

A case in which a self-expandable biodegradable (BD) esophageal stent was used for a refractory esophageal anastomotic stricture (EAS) in a 5-year-old female is presented. The patient underwent closure of a tracheoesophageal fistula and gastrostomy in the neonatal period. Esophagoesophagostomy was performed at 18 months of age after a multistaged extrathoracic esophageal elongation procedure. The patient developed refractory EAS and required repeated esophageal balloon dilation. Four sessions of esophageal BD stenting were performed from the age of 5–8 years. Each BD stenting allowed her to eat chopped food, but the anastomotic stricture recurred 4–7 months after the procedure. No major complications were observed, though transient chest pain and dysphagia were observed after each stenting. Finally, at 8 years of age, EAS resection and esophagoesophageal anastomosis were performed. The resected specimens showed thickened scar formation at the EAS lesion, while the degree of esophageal wall damage, both at the proximal and distal ends of the stricture, was slight. To the best of our knowledge, this is the first case report of this kind of treatment and assessment of damage to the esophageal wall microscopically. The advantages and problems of the use of BD stents in children are discussed.

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Disclosures

Conflict of Interest:

Yuichi Okata, Chieko Hisamatsu, Yuko Bitoh, Akiko Yokoi, Eiji Nishijima, Makiko Yoshida, Tsukasa Ishida, Takeshi Azuma, Kosaku Maeda, and Hiromu Kutusmi declare that they have no conflict of interest.

Human/Animal Rights:

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).

Informed Consent:

Informed consent was obtained from all patients for being included in the study.

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Correspondence to Yuichi Okata.

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Okata, Y., Hisamatsu, C., Bitoh, Y. et al. Efficacy and histopathological esophageal wall damage of biodegradable esophageal stents for treatment of severe refractory esophageal anastomotic stricture in a child with long gap esophageal atresia. Clin J Gastroenterol 7, 496–501 (2014). https://doi.org/10.1007/s12328-014-0537-8

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  • DOI: https://doi.org/10.1007/s12328-014-0537-8

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