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Outcomes of pneumatic dilation in pediatric caustic esophageal strictures: a descriptive and analytic study from a developing country

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Abstract

Objectives

Corrosive substance ingestion in children represents a significant public health issue due to its long-term health sequelae. Esophageal stricture, main complication of this dangerous condition, is treated by pneumatic dilation and eventually by esophageal replacement. We aimed, through this study, to report the outcomes of esophageal pneumatic dilation complicating corrosive substance ingestion in children in a developing country.

Methods

This cross-sectional study was performed on the population of pediatric patients with caustic esophageal stenosis between January 2005 and December 2020. All patients underwent pneumatic balloon dilation. A logistic regression model was built to predict the probability of the occurrence of the event (success/failure) of the dilation. The ROC curve is used to evaluate the performance of the logistic regression model to discriminate between positive and negative values of the dependent variable.

Results

The success rate of pneumatic balloon dilation was 80.4%. The median duration of overall management was 11 months. The severity of caustic stricture observed during endoscopy was significantly linked to worse outcomes (p = 0.001). Multivariate analysis indicated that the severity of stenosis and the number of dilation sessions were independent risk factors for failure of dilation. ROC curve analysis showed that the area under the curve was 71.7%. A Cut-Off point value of 7 provided the best sensitivity and specificity.

Conclusion

Pneumatic balloon dilation has been proven to be efficacious in infants with caustic esophageal stricture. Pediatric surgeons should take into account factors to promptly switch to replacement surgery and avoid unnecessary and time-consuming serial dilations.

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Authors and Affiliations

  1. Pediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia

    Ben Youssef Sabrine, Marwa Messaoud, Belhassen Samia, Ben Fredj Meriem, Ben Salah Radhouane, Sfar Sami, Mosbahi Sana, Ksia Amine, Sahnoun Lassaad, Mekki Mongi & Belghith Mohsen

  2. Anesthesiology Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia

    Ben Mansour Maha & Chakroun Sawsen

  3. Epidemiology and Preventive Medicine Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia

    Gara Amel & Zemni Imen

  4. University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia

    Ben Youssef Sabrine, Marwa Messaoud, Belhassen Samia, Ben Fredj Meriem, Ben Salah Radhouane, Ben Mansour Maha, Chakroun Sawsen, Sfar Sami, Mosbahi Sana, Ksia Amine, Gara Amel, Zemni Imen, Sahnoun Lassaad, Mekki Mongi & Belghith Mohsen

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  1. Ben Youssef Sabrine
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Correspondence to Ben Youssef Sabrine.

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Disclosures

Ben Youssef Sabrine, Marwa Messaoud, Belhassen Samia, Ben Fredj Meriem, Ben Salah Radhouane, Ben Mansour Maha, Chakroun Sawsen, Sfar Sami, Mosbahi sana, Ksia Amine, Gara Amel, Zemni Imen, Sahnoun Lassaad, Mekki Mongi, and Belghith Mohsen have no conflicts of interest or financial ties to disclose.

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Sabrine, B.Y., Messaoud, M., Samia, B. et al. Outcomes of pneumatic dilation in pediatric caustic esophageal strictures: a descriptive and analytic study from a developing country. Surg Endosc 37, 9291–9298 (2023). https://doi.org/10.1007/s00464-023-10489-w

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  • DOI: https://doi.org/10.1007/s00464-023-10489-w

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