Efficacy and safety of endoscopic dilatation in the management of esophageal strictures in children

Objectives : To determine the outcomes of endoscopic dilatationof esophageal stricturesin children. Methods : Children younger than 18 years of age diagnosed with esophageal stricturesover a period of 7 years (June 2010 to June 2017) were reviewed and analyzed retrospectively. The study took place at King Khalid University Hospital, Riyadh, Saudi Arabia. The patients’ clinical characteristics, endoscopic findings, and details of the strictures, treatment, and outcomes were documented. Results : Forty-three children with esophageal strictureswere identified (median age, 8.1 years; range, 2-17 years; 23 [53.5%] boys). The median age at presentation was 2 years (range, 1-16 years), and the median follow-up period was 3 years (range, one month-17 years). Tracheoesophageal fistula(n=14, 32.6%), gastroesophageal reflux disease (n=10, 23.3%) and eosinophilic esophagitis(n=8, 18.6%) were the leading causes of esophageal strictures. Forty-three patients underwent 180 dilatationsessions; the median number of dilatationsessions per patient was 3 (range, 1-48), and the median interval between sessions was 8 weeks (range, 1-24 weeks). Among 180 dilatationsessions, 3 events (1.7%) of esophagealperforation were observed. The outcomes varied depending on the primary cause of the stricture; complete response was achieved the best in eosinophilic esophagitis-related strictures (87.5%), followed by anastomotic strictures post tracheoesophageal fistularepair (71.4%) and gastroesophageal reflux disease-related strictures (70%). Conclusion : Endoscopic dilatationis a safe and effective intervention in the management of esophageal stricturesin children, with minimal complications when conducted by experts.