Factors affecting the outcome of endoscopic dilatation in refractory post-corrosive oesophageal stricture in Egyptian children: a single-centre study

Esophagus. 2020 Jul;17(3):330-338. doi: 10.1007/s10388-020-00727-8. Epub 2020 Feb 22.

Abstract

Background: An important complication of corrosive ingestion is oesophageal stricture. Improvements in endoscopes and accessories have supported an increase in the number of patients who are conservatively treated with endoscopic dilations. In this study, we aimed to detect factors affecting the outcome of endoscopic dilatation for refractory post-corrosive oesophageal stricture.

Methods: This study was carried out in the Paediatric Endoscopy Unit in the Children's Hospital and included 100 children older than 2 years of age of both sexes who had an established diagnosis of post-corrosive oesophageal stricture on repeated endoscopic dilatation sessions. The duration of the condition was more than 6 months, and dilatation failed to achieve a diameter of 14 mm during the first five sessions at 2-week intervals (refractory), excluding other causes of oesophageal stricture.

Results: Males represented 63% of patients. The mean age of enrolled children was 5.9 ± 2.6 years; 90% of patients ingested an alkaline corrosive substance (potash). The total number of dilatation sessions ranged from 16 to 100, with a mean number of sessions ranging from 37.2 ± 14.9. Fifty-four patients (54%) were well controlled by regular endoscopic dilatation with good clinical and endoscopic outcomes, and no more dilatations were needed.

Conclusion: Endoscopic dilation is an effective method for managing refractory post-corrosive oesophageal strictures that require a long follow-up period. There are a lot of factors affecting the outcome.

Keywords: Children; Endoscopic dilatation; Oesophageal strictures; Post-corrosive.

Publication types

  • Observational Study

MeSH terms

  • Aftercare
  • Burns, Chemical / complications
  • Burns, Chemical / pathology*
  • Caustics / adverse effects*
  • Child
  • Child, Preschool
  • Complex Mixtures / adverse effects
  • Dilatation / methods
  • Dilatation / statistics & numerical data*
  • Egypt / epidemiology
  • Endoscopy, Gastrointestinal / methods
  • Esophageal Stenosis / etiology
  • Esophageal Stenosis / pathology
  • Esophageal Stenosis / surgery*
  • Female
  • Humans
  • Male
  • Treatment Outcome

Substances

  • Caustics
  • Complex Mixtures
  • potash