Abstract
Esophageal strictures are uncommon in children. Noninvasive management of esophageal strictures is based on the same principles in children as in adults though there is much less published literature in pediatric practice. Bougienage and balloon dilation are effective and preferences of one technique over the other will depend on the situation. The major complication is perforation and is related to the characteristics of the stricture itself.
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References
Kramer RE, Quiros JA. Esophageal stents for severe strictures in young children: experience, benefits, and risk. Curr Gastroenterol Rep. 2010;12(3):203–10.
Nostrant TT, Nandi PS. Esophageal dilation. Gastroenterologist. 1998;6(1):5–15. Review.
Lang T, Hümmer HP, Behrens R. Balloon dilation is preferable to bougienage in children with esophageal atresia. Endoscopy. 2001;33:329–35.
Khan K. Endoscopic management of strictures in pediatrics. Tech Gastrointest Endosc. 2013;15(1):25–31.
Piotet E, Escher A, Monnier P. Esophageal and pharyngeal strictures: report on 1,862 endoscopic dilatations using the Savary-Gilliard technique. Eur Arch Otorhinolaryngol. 2008;265(3):357–64.
Spechler SJ. AGA, technical review on treatment of patients with dysphagia caused by benign disorders of the distal esophagus. Gastroenterology. 1999;117:233–54.
Lew RJ, Kochman ML. A review of endoscopic methods of esophageal dilatation. J Clin Gastroenterol. 2002;35:117–26.
Siersema PD. Treatment options for esophageal strictures. Nat Clin Pract Gastroenterol Hepatol. 2008;5:142–52.
Ezoe Y, Muto M, Horimatsu T, Morita S, et al. Efficacy of preventive endoscopic balloon dilation for esophageal stricture after endoscopic resection. J Clin Gastroenterol. 2011;45(3):222–7.
Loveland JA, Mitchell CE, van Wyk P, Beale P. Esophageal replacement in children with AIDS. J Pediatr Surg. 2010;45(10):2068–70.
Shorter NA, Mooney DP, Vaccaro TJ, Sargent SK. Hydrostatic balloon dilation of congenital esophageal stenoses associated with esophageal atresia. J Pediatr Surg. 2000;35(12):1742–5.
Siersema PD, de Wijkerslooth LR. Dilation of refractory benign esophageal strictures. Gastrointest Endosc. 2009;70(5):1000–12. Review.
Serhal L, Gottrand F, Sfeir R. Anastomotic stricture after surgical repair of esophageal atresia: frequency, risk factors, and efficacy of esophageal bougie dilatations. J Pediatr Surg. 2010;45(7):1459–62.
Khan K, Foker J. Use of high-resolution endoscopic ultrasound to examine the effect of tension of the esophagus during primary repair of long-gap esophageal Atresia. Pediatr Radiol. 2007;37(1):41–5.
Brown AK, Tam PKH. Measurement of gap length in esophageal atresia: a simple predication of outcome. J Am Coll Surg. 1996;182:41–5.
Foker JE, Kendall-Krosch TC, Katton K, Munroe F, Khan KM. Long-gap esophageal atresia treated by Growth induction: the biological potential and early follow-up results. Semin Pediatr Surg. 2009;18(1):23–9.
Wang H, Tan L, Feng M, Zhang Y, Wang Q. Comparison of the short-term health-related quality of life in patients with esophageal cancer with different routes of gastric tube reconstruction after minimally invasive esophagectomy. Qual Life Res. 2011;20(2):179–89.
Khan K, Sabati A, Kendall T, Foker J. The effect of traction of esophageal structure in children with long-gap esophageal atresia. Dig Dis Sci. 2006;51(11):1917–21.
Madanick RD, Shaheen NJ, Dellon ES. A novel balloon pull-through technique for esophageal dilation in eosinophilic esophagitis (with video). Gastrointest Endosc. 2011;73(1):138–42.
Takamizawa S, Tsugawa C, Mouri N, et al. Congenital esophageal stenosis: therapeutic strategy based on etiology. J Pediatr Surg. 2002;37(2):197–201.
Abele J. The physics of esophageal dilatation. Hepatogastroenterology. 1992;39:486.
Chung J, Connolly B, Langer J, Marcon M, Temple M, Amaral JG. Fluoroscopy-guided topical application of mitomycin-C in a case of refractory esophageal stricture. J Vasc Interv Radiol. 2010;21(1):152–5.
Yamaguchi N, Isomoto H, Shikuwa S, et al. Effect of oral prednisolone on esophageal stricture after complete circular endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma: a case report. Digestion. 2011;83(4):291–5.
Schembre DB. Recent advances in the use of stents for esophageal disease. Gastrointest Endosc Clin N Am. 2010;20(1):103–21.
Chung WC, Paik CN, Lee KM, Jung SH, Chang UI, Yang JM. The findings influencing restenosis in esophageal anastomotic stricture after endoscopic balloon dilation: restenosis in esophageal anastomotic stricture. Surg Laparosc Endosc Percutan Tech. 2009;19(4):293–7.
Scolapio JS, Pasha TM, Gostout CJ, et al. A randomized prospective study comparing rigid to balloon dilators for benign esophageal strictures and rings. Gastrointest Endosc. 1999;50:13–7.
DeVault KR. Lower esophageal (Schatzki’s) ring: pathogenesis, diagnosis and therapy. Dig Dis. 1996;14(5):323–9. Review.
Bapat RD, Bakhshi GD, Kantharia CV, Shirodkar SS, Iyer AP, Ranka S. Self-bougienage: long-term relief of corrosive esophageal strictures. Indian J Gastroenterol. 2001;20(5):180–2.
Okada T, Ohnuma N, Tanabe M, Iwai J, Yoshida H, Kuroda H, Takahashi H. Effective endless-loop bougienage through the oral cavity and esophagus to the gastrostomy in corrosive esophageal strictures in children. Pediatr Surg Int. 1998;13(7):480–6.
Dellon ES, Cullen NR, Madanick RD, et al. Outcomes of a combined antegrade and retrograde approach for dilatation of radiation-induced esophageal strictures (with video). Gastrointest Endosc. 2010;71(7):1122–9.
Mukherjee K, Cash MP, Burkey BB, et al. Antegrade and retrograde endoscopy for treatment of esophageal stricture. Am Surg. 2008;74:686–7.
Maple JT, Petersen BT, Baron TH, et al. Endoscopic management of radiation-induced complete upper esophageal obstruction with an antegrade-retrograde rendezvous technique. Gastrointest Endosc. 2006;64:822–8.
Saeed ZA, Winchester CB, Ferro PS, Michaletz PA, Schwartz JT, Graham DY. Prospective randomized comparison of polyvinyl bougies and through-the-scope balloons for dilation of peptic strictures of the esophagus. Gastrointest Endosc. 1995;41(3):189–95.
Cox JG, Winter RK, Maslin SC, et al. Balloon or bougie for dilatation of benign oesophageal strictures? An interim report of a randomized controlled trial. Gut. 1988;29:1741–7.
Riffat F, Cheng A. Pediatric caustic ingestion: 50 consecutive cases and a review of the literature. Dis Esophagus. 2009;22(1):89–94.
Gün F, Abbasoğlu L, Celik A, Salman ET. Early and late term management in caustic ingestion in children: a 16-year experience. Acta Chir Belg. 2007;107(1):49–52.
Contini S, Garatti M, Swarray-Deen A, Depetris N, Cecchini S, Scarpignato C. Corrosive oesophageal strictures in children: outcomes after timely or delayed dilatation. Dig Liver Dis. 2009;41(4):263–8.
Youn BJ, Kim WS, Cheon JE, et al. Balloon dilatation for corrosive esophageal strictures in children: radiologic and clinical outcomes. Korean J Radiol. 2010;11(2):203–10.
Pearson EG, Downey EC, Barnhart DC, et al. Reflux esophageal stricture – a review of 30 years’ experience in children. J Pediatr Surg. 2010;45(12):2356–60.
Said M, Mekki M, Golli M, et al. Balloon dilatation of anastomotic strictures secondary to surgical repair of oesophageal atresia. Br J Radiol. 2003;76(901):26–31.
Ko HK, Shin JH, Song HY, et al. Balloon dilation of anastomotic strictures secondary to surgical repair of esophageal atresia in a pediatric population: long-term results. J Vasc Interv Radiol. 2006;17(8):1327–33.
Antoniou D, Soutis M, Christopoulos-Geroulanos G. Anastomotic strictures following esophageal atresia repair: a 20-year experience with endoscopic balloon dilatation. J Pediatr Gastroenterol Nutr. 2010;51(4):464–7.
Koivusalo A, Pakarinen MP, Rintala RJ. Anastomotic dilatation after repair of esophageal atresia with distal fistula. Comparison of results after routine versus selective dilatation. Dis Esophagus. 2009;22(2):190–4.
Amae S, Nio M, Kamiyama T, et al. Clinical characteristics and management of congenital esophageal stenosis: a report on 14 cases. J Pediatr Surg. 2003;38(4):565–70.
Kochhar R, Makharia GK. Usefulness of intralesional triamcinolone in treatment of benign esophageal strictures. Gastrointest Endosc. 2002;56:829–34.
Altintas E, Kacar S, Tunc B, et al. Intralesional steroid injection in benign esophageal strictures resistant to bougie dilation. J Gastroenterol Hepatol. 2004;19:1388–91.
Ramage Jr JL, Rumalla A, Baron TH, et al. A prospective, randomized, double-blind, placebo-controlled trial of endoscopic steroid injection therapy for recalcitrant esophageal peptic strictures. Am J Gastroenterol. 2005;100:2419–25.
Morikawa N, Honna T, Kuroda T, et al. High dose intravenous methylprednisolone resolves esophageal stricture resistant to balloon dilatation with intralesional injection of dexamethasone. Pediatr Surg Int. 2008;24(10):1161–4.
Hirota WK, Wortmann GW, Maydonovitch CL, et al. The effect of oral decontamination with clindamycin palmitate on the incidence of bacteremia after esophageal dilation: a prospective trial. Gastrointest Endosc. 1999;50(4):475–9.
Mandelstam P, Sugawa C, Silvis SE, et al. Complications associated with esophagogastroduodenoscopy and with esophageal dilation. Gastrointest Endosc. 1976;23:16–9.
Hernandez LJ, Jacobson JW, Harris MS. Comparison among perforation rates of Maloney, balloon and Savary dilation of esophageal strictures. Gastrointest Endosc. 2000;51:460–2.
Yamamoto H, Hughes Jr RW, Schroeder KW, et al. Treatment of benign esophageal strictures by Eden-Puestow or balloon dilators: a comparison between randomized and prospective nonrandomized trials. Mayo Clin Proc. 1992;67:228–36.
Kang SG, Song HY, Lim MK, Yoon HK, Goo DE, Sung KB. Esophageal rupture during balloon dilation of strictures of benign or malignant causes: prevalence and clinical importance. Radiology. 1998;209(3):741–6.
Karnak I, Tanyel FC, Büyükpamukçu N, Hiçsönmez A. Esophageal perforations encountered during the dilation of caustic esophageal strictures. J Cardiovasc Surg (Torino). 1998;39(3):373–7.
Lan LC, Wong KK, Lin SC, et al. Endoscopic balloon dilatation of esophageal strictures in infants and children: 17 years’ experience and a literature review. J Pediatr Surg. 2003;38(12):1712–5.
Kim IO, Yeon KM, Kim WS, et al. Perforation complicating balloon dilation of esophageal strictures in infants and children. Radiology. 1993;189:741–4.
LaBerge JM, Kerlan Jr RK, Pogany AC, et al. Esophageal rupture: complication of balloon dilatation. Radiology. 1985;157:56–60.
Gerçek A, Ay B, Dogan V, Kiyan G, Dagli T, Gogus Y. Esophageal balloon dilation in children: prospective analysis of hemodynamic changes and complications during general anesthesia. J Clin Anesth. 2007;19(4):286–9.
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Khan, K.M. (2017). Strictures: Bougienage and Balloon Dilation. In: Till, H., Thomson, M., Foker, J., Holcomb III, G., Khan, K. (eds) Esophageal and Gastric Disorders in Infancy and Childhood. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11202-7_37
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DOI: https://doi.org/10.1007/978-3-642-11202-7_37
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