Dilatación endoscópica con balón de estenosis esofágica en niños / Endoscopic balloon dilatation of esophageal strictures in children

OBJETIVOS: Evaluar la eficacia y seguridad de la dilatación endoscópica con balón en niños con estenosis esofágica. PACIENTES Y MÉTODOS: Estudio retrospectivo de pacientes tratados en los últimos 5 años, con diagnóstico de estenosis esofágica. La respuesta a la dilatación fue considerada como excelente cuando con una sola sesión no hubo disfagia recurrente, satisfactoria cuando precisaron hasta 5 sesiones, aceptable con más de 5 sesiones, e inadecuada si no hubo mejoría de la disfagia con las dilataciones. El tratamiento fue efectivo cuando la disfagia grado 0 o 1 se mantuvo por más de 12 meses desde la última sesión. RESULTADOS: Fueron realizados 576 procedimientos en 89 niños, promedio de 6,47 por paciente (rango 1-33). La estenosis era secundaria a la reparación de una atresia esofágica en 51 casos (57,3%), a lesión por cáusticos en 19 pacientes (21,3%) y a reflujo gastroesofágico 11 casos(12,3%); con edades comprometidas entre 1 a 202 meses (media de36,1). La respuesta a la dilatación fue excelente en 11 pacientes (13,9%),satisfactoria en 27 (34,1%), aceptable en 25 (31,6%), e inadecuada en16 (20,2%). Diez pacientes (8,9%) fueron perdidos durante el seguimiento. Fueron diagnosticados de reflujo gastroesofágico patológico concomitante 34 pacientes (38,2%), todos recibieron manejo médico y 7 requirieron cirugía antirreflujo (20,5%). El tratamiento fue efectivo en 63 casos (79,7%) e inefectivo en 16 (20,2%), la mayoría de estos últimos con reflujo gastroesofágico. Tuvieron lugar 8 complicaciones (1,38%), todas perforaciones esofágicas. CONCLUSIONES: La dilatación endoscópica con balón es considerada segura y efectiva como el tratamiento de primera línea para estenosis esofágica

OBJECTIVES: To evaluate the effectiveness and safety of endoscopic balloon dilatation in children with esophageal stenosis. Patients and Methods. Retrospective study of patients treated in the last 5 years, diagnosed with esophageal stricture. Response to dilatation was defined as excellent when there was no need for any additional dilatation for recurrent dysphagia, satisfactory when they set out to 5 sessions, acceptable with more than 5 sessions, and inadequate if there was no improvement of dysphagia with dilation. The treatment was effective when dysphagia remained grade 0 or 1 was kept for more than 12 months after the last dilatation session. RESULTS: 576 procedures were performed in 89 children, with an average of 6,47 per patient (range 1-33). The esophageal stenosis was secondary to esophageal atresia repair in 51 cases (57,3%), injury by caustic in 19 patients (21,3%) and gastroesophageal reflux 11 cases (12,3%); compromised aged between 1-202 months (mean 36,1). Re-sponse to dilatation was excellent in 11 patients (13.9%), satisfactory in 27 (34.1%), fair in 25 (31.6%), and inadequate in 16 (20.2%). Ten patients (8.9%) were lost to follow up. Thirty-four (38.2%) patients were diagnosed with concomitant gastroesophageal reflux disease, every one recieved medical management and 7 (20,5%) underwent antireflux surgery. The treatment was effective in 63 cases (79.7%) and ineffective in 16 (20.2%), most of the latter with gastroesophageal reflux. There were 8 complications (1,38%), all esophageal perforations .Conclusions. Endoscopic balloon dilatation can be accomplished safely and effectively as a first-line therapy for the management of esophageal stenosis

[Endoscopic balloon dilatation of esophageal strictures in children]. / Dilatación endoscópica con balón de estenosis esofágica en niños.

OBJECTIVES: To evaluate the effectiveness and safety of endoscopic balloon dilatation in children with esophageal stenosis. PATIENTS AND METHODS: Retrospective study of patients treated in the last 5 years, diagnosed with esophageal stricture. Response to dilatation was defined as excellent when there was no need for any additional dilatation for recurrent dysphagia, satisfactory when they set out to 5 sessions, acceptable with more than 5 sessions, and inadequate if there was no improvement of dysphagia with dilation. The treatment was effective when dysphagia remained grade 0 or 1 was kept for more than 12 months after the last dilatation session. RESULTS: 576 procedures were performed in 89 children, with an average of 6,47 per patient (range 1-33). The esophageal stenosis was secondary to esophageal atresia repair in 51 cases (57,3%), injury by caustic in 19 patients (21,3%) and gastroesophageal reflux 11 cases (12,3%); compromised aged between 1-202 months (mean 36,1). Response to dilatation was excellent in 11 patients (13.9%), satisfactory in 27 (34.1%), fair in 25 (31.6%), and inadequate in 16(20.2%). Ten patients (8.9%) were lost to follow up. Thirty-four (38.2%) patients were diagnosed with concomitant gastroesophageal reflux disease, every one recieved medical management and 7 (20,5%) underwent antireflux surgery. The treatment was effective in 63 cases (79.7%) and ineffective in 16 (20.2%), most of the latter with gastroesophageal reflux. There were 8 complications (1,38%), all esophageal perforations. CONCLUSIONS: Endoscopic balloon dilatation can be accomplished safely and effectively as a first-line therapy for the management of esophageal stenosis.