Sherif M K Shehata1, Mohamed E Enaba. 1. Department of Pediatric Surgery, Internal Medicine, Tanta University Hospital, Tanta, Egypt.
Abstract
PURPOSE: The purpose of this study was to present the safety and effectiveness of an expectant protocol employing Savary-Gilliard dilatation in benign oesophageal stricture in infants and toddlers along a decade of experience. PATIENTS AND METHODS: Thirty eight infants and toddlers with benign oesophageal stricture with age ranged between 5 and 22 months were treated by modified dilatation protocol. Complications and outcomes of the dilatation protocol were reported during a follow-up period of 12 to 100 months. RESULTS: We have 25 cases of corrosive stricture, 4 congenital, 4 post-reflux and 5 post-anastomotic strictures. A total of 654 dilatations in 265 sessions were done. The corrosive subgroup has a mean dysphagia score of 2.6 pre-dilatation that improved at 6 months after end of dilatation to a mean of 0.3. In the non-corrosive subgroup, significant lower number of dilatation and sessions were reported. We have three failures that need surgery. Thirty five cases reach acceptable oesophageal caliber. Mucosal tear and small perforation each reported once. Small diverticulum reported twice. CONCLUSIONS: The expectant dilatation protocol is feasible in managing benign oesophageal stricture in infants and toddlers without increasing the morbidity. It is effective even in long segment or multiple corrosive strictures.
PURPOSE: The purpose of this study was to present the safety and effectiveness of an expectant protocol employing Savary-Gilliard dilatation in benign oesophageal stricture in infants and toddlers along a decade of experience. PATIENTS AND METHODS: Thirty eight infants and toddlers with benign oesophageal stricture with age ranged between 5 and 22 months were treated by modified dilatation protocol. Complications and outcomes of the dilatation protocol were reported during a follow-up period of 12 to 100 months. RESULTS: We have 25 cases of corrosive stricture, 4 congenital, 4 post-reflux and 5 post-anastomotic strictures. A total of 654 dilatations in 265 sessions were done. The corrosive subgroup has a mean dysphagia score of 2.6 pre-dilatation that improved at 6 months after end of dilatation to a mean of 0.3. In the non-corrosive subgroup, significant lower number of dilatation and sessions were reported. We have three failures that need surgery. Thirty five cases reach acceptable oesophageal caliber. Mucosal tear and small perforation each reported once. Small diverticulum reported twice. CONCLUSIONS: The expectant dilatation protocol is feasible in managing benign oesophageal stricture in infants and toddlers without increasing the morbidity. It is effective even in long segment or multiple corrosive strictures.
Authors: Raf Bisschops; Miguel Areia; Emmanuel Coron; Daniela Dobru; Bernd Kaskas; Roman Kuvaev; Oliver Pech; Krish Ragunath; Bas Weusten; Pietro Familiari; Dirk Domagk; Roland Valori; Michal F Kaminski; Cristiano Spada; Michael Bretthauer; Cathy Bennett; Carlo Senore; Mário Dinis-Ribeiro; Matthew D Rutter Journal: United European Gastroenterol J Date: 2016-08-21 Impact factor: 4.623
Authors: Alessia Ghiselli; Barbara Bizzarri; Daniela Ferrari; Elisabetta Manzali; Federica Gaiani; Fabiola Fornaroli; Antonio Nouvenne; Francesco Di Mario; Gian Luigi De'Angelis Journal: Acta Biomed Date: 2018-12-17