Marom Adi, Davidovics Zev, Bdolah-Abram Tali, Ledder Oren
Hebrew University- Hadassah Medical School, Jerusalem, Israel.
Department of Pediatric Gastroenterology, Hadassah Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel.
Dis Esophagus. 2022 Dec 31;36(1). doi: 10.1093/dote/doac048.
Esophageal strictures in children may cause dysphagia, choking during feeds, and failure to thrive. They can be treated by balloon dilatations, either under endoscopic or fluoroscopic guidance; there is no literature comparing the methods. Retrospective review of the medical records of children (0-18 years) who were treated with balloon dilatations between 2010 and 2020. The primary outcome was the number of dilatation sessions required until clinical success after 3 months. Secondary outcomes were long-term success at 12 months, and complications of bleeding and perforation. Forty-six patients underwent 174 dilatation sessions. Success rates in the endoscopy and fluoroscopy groups were similar: 62% versus 67% (p = 0.454) at 3 months and 57% versus 67% (p = 0.721) at 12 months. Complication rate was lower in the endoscopy group (0% vs. 15%, p < 0.001). Both endoscopic and radiologic-guided balloon dilatations were shown to be equally effective, but endoscopic guidance had fewer complications.
儿童食管狭窄可能导致吞咽困难、进食时呛噎及发育不良。可在内镜或透视引导下通过球囊扩张术进行治疗；尚无文献对这两种方法进行比较。回顾性分析2010年至2020年间接受球囊扩张术治疗的0至18岁儿童的病历。主要结局是3个月后直至临床成功所需的扩张次数。次要结局是12个月时的长期成功率以及出血和穿孔并发症。46例患者接受了174次扩张治疗。内镜组和透视组的成功率相似：3个月时分别为62%和67%（p = 0.454），12个月时分别为57%和67%（p = 0.721）。内镜组的并发症发生率较低（0%对15%，p < 0.001）。结果表明，内镜引导和放射引导下的球囊扩张术同样有效，但内镜引导的并发症较少。
