Congenital oesophageal stenosis in oesophageal atresia: underrecognised and often missed?

Braungart, Sarah; Peters, Robert; Lansdale, Nick; Wilkinson, David

doi:10.1007/s00383-021-05036-4

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…Although the association of CES with EA had been considered rare [ 6 , 10 ], recent publications and a systematic review suggested that the association has been underrecognized [ 3 – 5 ]. Surgical resection has been the predominant approach for treating EA-associated CES [ 5 ], and no studies have explored the efficacy of balloon dilatation. Here we reviewed EA-associated CES patients treated at our institution.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…There is currently no general agreement on the optimal management of CES associated with EA (EA-associated CES) [ 5 , 6 ]. In most cases, surgical resection was the treatment of choice for CES lesions because dilation was unsuccessful [ 5 ]. However, in EA-associated CES, the resection of CES lesions is sometimes complicated due to reduced blood supply in the lower esophagus or preexisting intrathoracic adhesions caused by thoracotomy for EA repair.…”

Section: Introductionmentioning

confidence: 99%

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Balloon dilatation for congenital esophageal stenosis associated with esophageal atresia

Deguchi,

Kamiyama,

Masahata

et al. 2024

Pediatr Surg Int

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Purpose Congenital esophageal stenosis (CES) associated with esophageal atresia (EA) is rare, and no standard treatment has been established. We reviewed cases of EA-associated CES to assess the clinical characteristics and treatment outcomes, especially the feasibility of endoscopic dilatation. Methods We retrospectively examined patients with EA-associated CES. We also compared treatment outcomes of EA-associated CES with those of EA patients without CES who developed postoperative anastomotic stricture. Results Among 44 patients with EA, ten had CES (23%). Postoperative complications were not significantly different between EA patients with CES and those without CES but with anastomotic stricture. All CES patients underwent balloon dilatation as initial treatment. Eight of nine patients (89%) were successfully treated by dilatation only, and one patient underwent surgical resection. The median number of balloon dilatations for CES was five (2–17), which was higher than that for anastomotic stricture in patients without CES (p = 0.012). Esophageal perforation occurred in five patients with CES (5/9, 56%) after dilatation, but all perforations were successfully managed conservatively with an uneventful post-dilatation course. Conclusions Twenty-three percent of patients with EA had CES. Although balloon dilatation for EA-associated CES required multiple treatments and carried a risk of perforation, balloon dilatation showed an 89% success rate and all perforations could be managed conservatively.

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