Custom dynamic stent for esophageal strictures in children.

Abstract

BACKGROUND:

Esophageal stenting represents a new strategy to avoid multiple dilations owing to stenosis relapse. Our custom stent improves esophageal motility unlike the widespread self-expandable plastic esophageal stents. The aim of the study was to confirm the efficacy of treatment with silicone custom stents in esophageal stenosis (ES) in pediatric patients.

METHODS:

A silicone stent of 7-, 9-, or 12.7-mm external diameter is built coaxially on a nasogastric tube that guarantees the correct position. The 2 ends are tailored to allow food passage between stent and esophageal wall. All patients received dexamethasone (2 mg/kg per day) for 3 days and ranitidine/proton-pump inhibitors. Study approval was obtained from our ethical board.

RESULTS:

From 1988 to 2010, 79 patients with ES, mean age 35.4 months (3-125 months), underwent esophageal hydrostatic/Savary dilations and custom-stent placement, left in place for at least 40 days. Stenting was effective in 70 (88.6%) of 79 patients. Fifty percent of the patients with effective treatment received only one dilation for stent placement. Fourteen patients received more stents successfully. There was one stent-related major complication.

CONCLUSION:

Our custom stent improves treatment in ES. In caustic injuries, ES stenting represents the first option. In postsurgical ES, we stent after at least 5 dilations.

• Authors: Francesca Foschia, Paola De Angelis, Filippo Torroni, Erminia Romeo, Tamara Caldaro, Giovanni Federici di Abriola, Alessandro Pane, Maria Stella Fiorenza, Francesco De Peppo, Luigi Dall'Oglio
• Journal: Journal of pediatric surgery (J Pediatr Surg) Vol. 46 Issue 5 Pg. 848-53 (May 2011) ISSN: 1531-5037 [Electronic] United States
• PMID: 21616239 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Chemical References

• Caustics
• Proton Pump Inhibitors
• Dexamethasone

Topics

• Antibiotic Prophylaxis
• Burns, Chemical (therapy)
• Caustics (adverse effects)
• Child
• Child, Preschool
• Dexamethasone (administration & dosage, therapeutic use)
• Dilatation (instrumentation)
• Equipment Design
• Esophageal Motility Disorders (prevention & control)
• Esophageal Perforation (etiology)
• Esophageal Stenosis (chemically induced, etiology, therapy)
• Female
• Humans
• Infant
• Intubation, Gastrointestinal
• Male
• Postoperative Complications (therapy)
• Proton Pump Inhibitors (administration & dosage, therapeutic use)
• Radiation Injuries (therapy)
• Stents (adverse effects)