Esophageal Stents for Severe Strictures in Young Children: Experience, Benefits, and Risk

Abstract

The use of esophageal stents has been commonplace in adults for many years and for a variety of indications, including palliative care for malignant lesions involving the esophagus. The use of esophageal stents in the pediatric population, however, was limited by the inability to remove them and the implications this has for the growing child, especially for primarily benign esophageal lesions. With the advent of removable, covered stents, the potential uses for stents in children expanded to include treatment of a wide variety of congenital and acquired esophageal strictures. Stenting offers tremendous potential advantage over more traditional pneumatic or bougie dilation in its ability to provide continuous, radially oriented dilation pressure sustained over a period of time. This review examines the published pediatric literature on stents, discusses the indications for their use, outlines the types of stents available, offers technical guidance for proper placement, and reviews subsequent management and complications.

Efficacy and histopathological esophageal wall damage of biodegradable esophageal stents for treatment of severe refractory esophageal anastomotic stricture in a child with long gap esophageal atresia

“…In pediatric patients, the use of SEMSs or SEPSs is limited, because the degree of damage to the esophageal wall following stenting is unclear [10,11], and esophageal stents have been fundamentally adapted only for the treatment of stenosis secondary to malignant lesions. Thus, their long-term effects on the human body are unknown.…”

Custom dynamic stent for esophageal strictures in children

“…This stent represented an important improvement in the treatment of children with benign ES because of its tolerance by patients and their families. The absence of the NGT was initially thought to be very important; however, the risk of stent migration and adhesion is very high [14]. In this review, the authors compared the published series of patients with stent treatment.…”

Equipment for pediatric endoscopy

“…As in adults, stent migration is common, occurring in 10% to 29% of all cases. 115 Chest pain and vomiting occurred in 8 of 8 of patients in 1 study 80 and dysphagia and respiratory distress in 29% and 14% of patients, respectively, in another. 78 The primary risk of CE is retention, occurring in 1.4% of patients in 1 series.…”