Geng Lan-Lan, Liang Cui-Ping, Chen Pei-Yu, Wu Qiang, Yang Min, Li Hui-Wen, Xu Zhao-Hui, Ren Lu, Wang Hong-Li, Cheng Shunxian, Xu Wan-Fu, Chen Yang, Zhang Chao, Liu Li-Ying, Li Ding-You, Gong Si-Tang
Department of Gastroenterology, Guangzhou Women and Children's Medical Center, 9 Jinsui Road, Guangzhou 510623, China.
Division of Gastroenterology, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA.
Gastroenterol Res Pract. 2018 Aug 8;2018:8352756. doi: 10.1155/2018/8352756. eCollection 2018.
Caustic esophageal stricture (CES) in children still occurs frequently in developing countries. We aimed to evaluate the long-term outcomes of endoscopic balloon dilatation (EBD) in treating CES in children and the influencing factors associated with outcome. We retrospectively reviewed the data of all patients who had a diagnosis of CES and underwent EBD from August 1, 2005, to December 31, 2014. The primary outcome was EBD success, which was defined as the maintenance of dysphagia-free status for at least 12 months after the last EBD. The secondary outcome was to analyze influencing factors associated with EBD success. Forty-three patients were included for analysis (29 males; mean age at first dilatation 44 months with range 121 months). 26 (60.5%) patients had long segment (>2 cm) stricture. A total of 168 EBD procedures were performed. Twenty-six (60.5%) patients were considered EBD success. Seventeen (39.5%) patients failed EBD and required stent placement and/or surgery. Patients in the EBD success group had significantly shorter stricture segments when compared to the EBD failure group ( = 2.398, = 0.018, OR = 3.206, 95% OR: 1.228-8.371). Seven (4.4%) esophageal perforations occurred in 6 patients after EBD. Stents were placed in 5 patients, and gastric tube esophagoplasty was performed in 14 patients. In conclusion, 26 (60.5%) of 43 children with CES had EBD success. Length of stricture was the main influencing factor associated with EBD treatment outcome.
腐蚀性食管狭窄（CES）在发展中国家的儿童中仍频繁发生。我们旨在评估内镜下球囊扩张术（EBD）治疗儿童CES的长期疗效以及与疗效相关的影响因素。我们回顾性分析了2005年8月1日至2014年12月31日期间所有诊断为CES并接受EBD治疗的患者的数据。主要结局是EBD成功，定义为末次EBD后至少12个月维持无吞咽困难状态。次要结局是分析与EBD成功相关的影响因素。纳入43例患者进行分析（男29例；首次扩张时平均年龄44个月，范围12 - 11个月）。26例（60.5%）患者存在长节段（>2 cm）狭窄。共进行了168次EBD操作。26例（60.5%）患者被认为EBD成功。17例（39.5%）患者EBD失败，需要置入支架和/或手术治疗。与EBD失败组相比，EBD成功组患者的狭窄节段明显更短（t = 2.398，P = 0.018，OR = 3.206，95% OR：1.228 - 8.371）。6例患者在EBD后发生7次（4.4%）食管穿孔。5例患者置入了支架，14例患者进行了胃管食管成形术。总之，43例CES儿童中有26例（60.5%）EBD成功。狭窄长度是与EBD治疗结局相关的主要影响因素。
