Abstract
Background
The esophageal stricture is an important clinical problem in children, and the treatment is difficult.
Objective
To evaluate the results of fluoroscopy-guided balloon dilatation of benign pediatric esophageal strictures and to suggest a safety range for balloon diameters.
Materials and methods
We retrospectively reviewed the medical records of children who underwent fluoroscopy-guided esophageal balloon dilatation for treatment of benign esophageal stricture from February 2008 to July 2019. We recorded the demographic data of the children, technical details of each procedure, balloon diameter, number of repeated procedures, clinical and technical success rates, complications and follow-up period. Technical success was defined as the disappearance of the waist formation on the balloon catheter, and clinical success was defined as no need for re-dilation or other treatment methods during the 1-year follow-up after the procedure. These children were divided into groups and evaluated according to esophageal stricture etiology.
Results
Technically successful procedures included 375 balloon dilatations in 116 patients (67 boys; age range: 1 month to 18 years; mean age: 4.3 ± 4.8 standard deviation [SD] years at the initial dilatation). The follow-up period was 1–138 months (median: 41 months; mean: 44 months) since the last dilatation. In this study, the clinical success rate was 34% per procedure (120 of 353 procedures) and 85% per patients (91 of 107 patients). The total complication rate per procedure was 0.5%, and the perforation rate was 0.25% per session.
Conclusion
Fluoroscopy-guided esophageal balloon dilatation is an effective and reliable method for treating benign esophageal strictures in children.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Sandgren K, Malmfors G (1998) Balloon dilatation of oesophageal strictures in children. Eur J Pediatr Surg 8:9–11
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 17:17–33
London RL, Trotman BW, DiMarino AJ Jr et al (1981) Dilatation of severe esophageal strictures by an inflatable balloon catheter. Gastroenterology 80:173–175
Fasulakis S, Andronikou S (2003) Balloon dilatation in children for oesophageal strictures other than those due to primary repair of oesophageal atresia, interposition or restrictive fundoplication. Pediatr Radiol 33:682–687
Zhou WZ, Song HY, Park JH et al (2017) Incidence and management of oesophageal ruptures following fluoroscopic balloon dilatation in children with benign strictures. Eur Radiol 27:105–112
Sacks D, McClenny TE, Cardella JF, Lewis CA (2003) Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 14:199–202
Yeming W, Somme S, Chenren S et al (2002) Balloon catheter dilatation in children with congenital and acquired esophageal anomalies. J Pediatr Surg 37:398–402
Blount KJ, Lambert DL, Shaffer HA Jr, de Lange EE (2010) Fluoroscopically guided balloon dilation of the esophagus. Semin Intervent Radiol 27:232–240
Jayakrishnan VK, Wilkinson AG (2001) Treatment of oesophageal strictures in children: a comparison of fluoroscopically guided balloon dilatation with surgical bouginage. Pediatr Radiol 31:98–101
Chang CH, Chao HC, Kong MS et al (2019) Clinical and nutritional outcome of pediatric esophageal stenosis with endoscopic balloon dilatation. Pediatr Neonatol 60:141–148
Cakmak M, Boybeyi O, Gollu G et al (2016) Endoscopic balloon dilatation of benign esophageal strictures in childhood: a 15-year experience. Dis Esophagus 29:179–184
Doo EY, Shin JH, Kim JH, Song HY (2009) Oesophageal strictures caused by the ingestion of corrosive agents: effectiveness of balloon dilatation in children. Clin Radiol 64:265–271
Hu HT, Shin JH, Kim JH et al (2015) Fluoroscopically guided large balloon dilatation for treating congenital esophageal stenosis in children. Jpn J Radiol 33:418–423
Uygun I, Arslan MS, Aydogdu B et al (2013) Fluoroscopic balloon dilatation for caustic esophageal stricture in children: an 8-year experience. J Pediatr Surg 48:2230–2234
Weintraub JL, Eubig J (2006) Balloon catheter dilatation of benign esophageal strictures in children. J Vasc Interv Radiol 17:831–835
Chetcuti P, Phelan PD (1993) Gastrointestinal morbidity and growth after repair of oesophageal atresia and tracheo-oesophageal fistula. Arch Dis Child 68:163–166
Chapuy L, Pomerleau M, Faure C (2014) Topical mitomycin-C application in recurrent esophageal strictures after surgical repair of esophageal atresia. J Pediatr Gastroenterol Nutr 59:608–611
Hamza AF, Abdelhay S, Sherif H et al (2003) Caustic esophageal strictures in children: 30 years’ experience. J Pediatr Surg 38:828–833
Thomson M, Tringali A, Dumonceau JM et al (2017) Paediatric gastrointestinal endoscopy: European Society for Paediatric Gastroenterology Hepatology and Nutrition and European Society of Gastrointestinal Endoscopy guidelines. J Pediatr Gastroenterol Nutr 64:133–153
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
None
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Kahriman, G., Hosgecin, C., Herdem, N. et al. Fluoroscopy-guided balloon dilatation of benign esophageal strictures in children: 11-year experience. Pediatr Radiol 52, 977–984 (2022). https://doi.org/10.1007/s00247-021-05253-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-021-05253-y