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TÜRKÇE
Oral Presentation - 10
Esophageal Stent Placement for Pediatric Esophageal Strictures: Safety, Efficacy, and Long-Term Outcomes
S Fkaier, M Messaoud, S Ben Youssef, N Zribi, A Ksia, L Sahnoun, M Mekki, M Belghith
Fattouma Bourguiba Hospital Monastir Tunisia
Introduction:
The use of esophageal stents in the management of esophageal stenosis in children is still evolving and challenging.
We aimed to evaluate our experience and investigate whether esophageal stents could be used safely and effectively.
Methods:
Charts of patients with caustic or anastomotic esophageal strictures, having undergone esophageal stent placement, from 2006 to 2020 were retrospectively reviewed. The failure of medical treatment and balloon dilations indicated the procedure. It was performed under direct endoscopic or fluoroscopic guidance or both of them. Self-expanding silicone stent (Polyflex) was used for all patients. Clinical data, operative findings and outcomes were analyzed.
Results:
Twenty-three cases were included in the study (13 girls, 10 boys), mean operative age was 4.5 years, caustic stenosis was the first etiology in our series (22 cases) followed by anastomotic esophageal stricture (1 cases). The strictures Length were over 5 cm only in 2 cases, between 2-5 cm in the other cases. An average of 8 sessions per patient of dilation were realized prior to stent placement. Mean time of the procedure was 40 min. Stents were complicated with chest pain and immediate dysphagia in 2 cases, perforation conservatively managed only in one case and migration in 8 cases. Removal of the stents was performed after 3 weeks to 10 months. With follow-up improvement of dysphagia was reported in 13 of patients (57%), 7 children need further dilations, 7 children needed esophageal replacement.
Conclusion:
Esophageal stents may serve as a bridge to definitive surgical repair in the management of esophageal strictures. In our experience, esophageal stents were safe, quick and reliable. However, the development of esophageal stents with improved flexibility, anti-migration features and smaller diameters and lengths could further increase their successful application in children.