Balloon dilation is preferable to bougienage in children with esophageal atresia

Endoscopy
T LangR Behrens

Abstract

Esophageal strictures are a common problem after surgical repair in children with esophageal atresia. The traditional procedure in these patients is dilation using bougie dilators, usually controlled fluoroscopically or endoscopically. Nowadays, an alternative technique is balloon-catheter dilation. The aim of this study was to report our experience with pneumatic balloon dilation and to compare this method with previously performed bougienage with regard to efficacy. Over 16 years, 34 patients who developed symptomatic strictures were encountered at our institution. In the first 9 years 12 patients underwent 178 bougienages (group C). In the last 7 years six patients who had undergone 202 previous bougienages (group B), and 16 patients who had undergone no bougienages (group A), underwent 52 dilations. The dilation was carried out under intravenous sedation using a combination of midazolam and etomidate. The balloon was placed in the stricture endoscopically and the procedure was performed under fluoroscopic and endoscopic control. In all patients the dilation was effective and involved minimal trauma. The strictures required 1 to 7 procedures (median 2) over a maximum of 18 months (median 3 months) for a good treatment result...Continue Reading

Citations

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