Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2020; 26(10): 1080-1087
Published online Mar 14, 2020. doi: 10.3748/wjg.v26.i10.1080
Predictors of outcomes of endoscopic balloon dilatation in strictures after esophageal atresia repair: A retrospective study
Dong-Ling Dai, Chen-Xi Zhang, Yi-Gui Zou, Qing-Hua Yang, Yu Zou, Fei-Qiu Wen
Dong-Ling Dai, Chen-Xi Zhang, Yi-Gui Zou, Qing-Hua Yang, Yu Zou, Fei-Qiu Wen, Department of Gastroenterology, Shenzhen Children's Hospital, 7019 Yitian Road, Futian District, Shenzhen 518036, Guangdong Province, China
Author contributions: Dai DL conceived and designed the study; Wen FQ served as a scientific advisor; Dai DL treated the patients by endoscopic balloon dilatation and prepared the manuscript; Zhang CX, Zou YG, and Yang QH took care of the patients and collected, analyzed, and interpreted the data; Zou YG analyzed the data.
Supported by the Shenzhen Innovation and Technology Committee, No. JCYJ20180228175150018; and the Guangdong Medical Research Foundation (CN), No. A2018550.
Institutional review board statement: The study was reviewed and approved for publication by the Ethics Committee of Shenzhen Children’s Hospital.
Informed consent statement: Informed consent was waived due to the retrospective nature of this study.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
Data sharing statement: All data underlying the findings are fully available without restriction. All relevant data are included in this published article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Fei-Qiu Wen, MD, PhD, Chief Doctor, Gastroenterology Department, Shenzhen Children’s Hospital, 7019 Yitian Road, Futian District, Shenzhen 518036, Guangdong Province, China. fwen62@163.com
Received: December 4, 2019
Peer-review started: December 4, 2019
First decision: December 30, 2019
Revised: January 10, 2020
Accepted: February 15, 2020
Article in press: February 15, 2020
Published online: March 14, 2020
Processing time: 101 Days and 13.8 Hours
Abstract
BACKGROUND

Endoscopic balloon dilatation (EBD) has become the first line of therapy for benign esophageal strictures (ESs); however, there are few publications about the predictive factors for the outcomes of this treatment.

AIM

To assess the predictive factors for the outcomes of EBD treatment for strictures after esophageal atresia (EA) repair.

METHODS

Children with anastomotic ES after thoracoscopic esophageal atresia repair treated by EBD from January 2012 to December 2016 were included. All procedures were performed under tracheal intubation and intravenous anesthesia using a three-grade controlled radial expansion balloon with gastroscopy. Outcomes were recorded and predictors of the outcomes were analyzed.

RESULTS

A total of 64 patients were included in this analysis. The rates of response, complications, and recurrence were 96.77%, 8.06%, and 2.33%, respectively. The number of dilatation sessions and complications were significantly higher in patients with a smaller stricture diameter (P = 0.013 and 0.023, respectively) and with more than one stricture (P = 0.014 and 0.004, respectively). The length of the stricture was significantly associated with complications of EBD (P = 0.001). A longer interval between surgery and the first dilatation was related to more sessions and a poorer response (P = 0.017 and 0.024, respectively).

CONCLUSION

The diameter, length, and number of strictures are the most important predictive factors for the clinical outcomes of endoscopic balloon dilatation in pediatric ES. The interval between surgery and the first EBD is another factor affecting response and the number of sessions of dilatation.

Keywords: Children; Endoscopic balloon dilatation; Esophageal stricture; Outcome; Predictor

Core tip: In this study, we evaluated the safety, efficacy, and predictors of the outcome of endoscopic balloon dilatation treatment for strictures after esophageal atresia repair. We found that the diameter, length, and number of strictures were the most important predictive factors for successful endoscopic balloon dilatation treatment for anastomotic esophageal strictures. An earlier dilation after 4 wk of surgery contributed to a better response and fewer dilation sessions.