Refractory strictures post-esophageal atresia repair: what are the alternatives?
Dis Esophagus
; 26(4): 382-7, 2013.
Article
in En
| MEDLINE
| ID: mdl-23679028
ABSTRACT
Esophageal strictures remain the most frequent complication after esophageal atresia (EA) repair despite refinements in operative techniques. With an incidence of anastomotic stricture between 8% and 49%, EA is the most frequent cause of benign esophageal stricture in children. The mainstay of treatment for esophageal stricture is dilatation with a 58-96% success rate. In order to relieve dysphagia, between 1 and 15 dilatations will be required in each EA patient with an esophageal stricture. However dilatations may lead to complications including perforation (0.1-0.4% of all esophageal benign strictures) and sociopsychological morbidity. Fifty percent of EA strictures will improve in 6 months. However, 30% will persist and require repeat dilatations. The present article explores the variety of non-surgical alternative treatments for anastomotic strictures after EA repair, focusing on triamcinolone acetonide, mitomycin C and esophageal stents. We propose an algorithm for a more standardized therapeutic approach, with the hope that an international panel of experts could meet and establish a consensus.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Esophageal Atresia
/
Esophageal Stenosis
Type of study:
Etiology_studies
/
Prognostic_studies
Limits:
Humans
/
Newborn
Language:
En
Journal:
Dis Esophagus
Journal subject:
GASTROENTEROLOGIA
Year:
2013
Document type:
Article