Report Of24Cases By Endoscopic Treatment Of Childrend With Benign Esophageal Stricture

Objective:To investigate the efficacy and differences of endoscopic dilation treatment in children with benign esophageal stenosis.Methods:Collected the data of24esophageal benign esophageal stenosis cases of children treatment in the1st Hospital of Guangxi Medical University from January2001to November2011.Before the endoscopy treatment upper gastrointestinal barium meal and endoscopy were perfored to clear the nature, location and extent of esophageal stricture.24cases with benign esophageal stenosis were treated by bougienage and/or balloon dilation, stent implantation. Data were retrospectively analyzed by statistical to evaluate the efficacy and safty of the endoscopic dilatation methods.Results:24children with benign esophageal strictures were perforemed76times of dilatations. There were7anastomotic stenosis(29.17%),10stenosis after chemical burn(41.67%),3achalasia(12.5%),3congenital esophageal stenosis(12.5%),1esophageal stenosis due to parotid postoperative injury(4.17%). Among24children,the minimum age were100days, the maximum age were14years, and the median age were10.02years.4cases can not exchange guide wire after gastroscopy (5.26%).9cases of dilations underwent APC burning (11.84%), and one case placed the esophagus CZES metallic stents bracket bougienage after1time balloon dilatation and4times bougienages. In all cases, bougienages accounted for59cases (77.63%), balloon dilatation in6cases (7.89%), pneumatic dilation in7cases (9.21%),2cases appear esophageal perforation secondary to bougienage, and soon transfer to surgical treatment (2.63%), three cases were performed by an interventional radiologist. The former narrow segment from the incisors average were20.3±7.38cm, with the median of18.3cm, and the average narrow diameter were0.48±0.21cm before dilation,with the median diameter0.45cm. Dysphagia scores and narrow diameter were significantly greater than that of pre-enlargement (P<0.05). After dilator treatment,2cases(2.63%) occurred subcutaneous emphysema and3cases appear fever (3.95%), these complications were cured after treatment. Hydrostatic balloon dilation group, dysphagia grade and narrow diameter were no significant difference (P>0.05) among the compared with bougie group, pneumatic dilation group.Conclusions:Endoscopic therapy dilation is safe and effective methods to improve the symptoms of dysphagia due to chemical agent injury, congenital esophagostenosis and anastomotic stenosis post esophageal surgery. Esophageal perforation was one of the serious complications. Recent efficacy were no significant difference between bougie group, pneumatic dilation group and hydrostatic balloon dilation group.