Journal of Gastrointestinal & Digestive System
Open Access

Research Article

Balloon or Bougienage Dilation for Esophageal Stenosis in Children?

Adi Gurfinkel¹, Amir Ben-Tov¹, Isaac Kori², Hagith Nagar³, Itzhak Vinograd³, Shimon Reif¹ and Shlomi Cohen^1*

¹The Pediatric Gastroenterology Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel

²Interventional Radiology, Department of Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel

³Department of Pediatric Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel

*Corresponding Author:

Shlomi Cohen
MD, Pediatric Gastroenterology Unit
"Dana-Dwek" Children's Hospital
Tel Aviv Medical Center, 6 Weizman Street
Tel Aviv, Israel, 6423906
Tel: 972-3-6974519
Fax: 972-3-6974181
E-mail: shlomico@tlvmc.gov.il

Received date: Nov 11, 2015, Accepted date: Dec 7, 2015, Published date: Dec 15, 2015

Citation: Gurfinkel A, Ben-Tov A, Kori I, Nagar H, Vinograd I, et al. (2015) Balloon or Bougienage Dilation for Esophageal Stenosis in Children?. J Gastrointest Dig Syst 5:361. doi:10.4172/2161-069X.1000361

Copyright:© 2015 Gurfinkel A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Purpose: Esophageal stenosis (ES) in children is defined as a fixed intrinsic narrowing of the esophagus caused by numerous etiologies. Treatment mainly consists of intraluminal dilation using balloon or Savary-Gilliard bougies. Methods: We retrospectively reviewed all medical records of children with ES treated by balloon or bougies. Our aim of this study was to compare both method of esophageal dilation in terms of safety, short- and long-term outcome. Results: Forty-two children were included in this study, 22 males (52%), mean age at diagnosis was 3.9 ± 5.7 years. This group underwent 190 dilation procedures in our institution between 1994-2013. The median treatment period was 5.5 months and the median follow-up after the last dilation was 2.25 years. The average number of dilations was 4.5 (range 1-22). Twenty-four patients had anastomotic stricture after surgical treatment of esophageal atresia (57.1%), 8 had stenosis following caustic ingestion (19%), 3 had functional stenosis due to esophageal motility disorders (achalasia) (7.1%) and the others (16.7%) had congenital ES, eosinophilic esophagitis, foreign body ingestion, or were post-fundoplication. Dilations were defined as failures in 11 children (26.2%). The success rate was 87% for the bougienage group (13 children) and 67% for the balloon group (18 children) (p=NS). The success rate was 75% (24 children) after caustic ingestion and surgical correction of esophageal atresia. There were 6 (3.1%) procedure-related complications that included 2 cases of aspiration pneumonia and 4 esophageal perforations. Conclusions: Esophageal dilation in children is a safe procedure with a high rate of long-term success. Longterm success of dilation among children with ES depends primarily on the etiology of stenosis and less on the method of dilation.

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