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小儿良性食管病变内镜下球囊扩张术的临床疗效

Clinical outcome of endoscopic balloon dilatations employed in benign paediatric oesophageal pathologies.

作者信息

Durakbasa Cigdem Ulukaya, Ersoy Furkan, Pirim Ahmet, Oskayli Meltem Caglar

机构信息

Department of Pediatric Surgery, Istanbul Medeniyet University Faculty of Medicine, Goztepe Dr. Suleyman Yalcin Sehir Hospital, Istanbul, Turkey.

出版信息

J Minim Access Surg. 2023 Jan-Mar;19(1):62-68. doi: 10.4103/jmas.jmas_79_22.

Abstract

BACKGROUND

Oesophageal dilatations can be done either by bougies or balloons for differing aetiologies in children. We investigated the efficacy and safety of endoscopic balloon dilatations (EBDs) employed by a single surgeon.

PATIENTS AND METHODS

Relevant data over 12 years were retrospectively evaluated with an ethical committee approval.

RESULTS

Ninety-seven children underwent 514 EBD with a median EBD of 3 (1-50). The primary diagnoses were oesophageal atresia (OA) in 51 children, corrosive ingestion in 21, peptic strictures in 13, achalasia in 8 and congenital oesophageal stenosis in 4. The balloon size varied between 3 and 30 mm. The EBD was successfully ended in 72 patients and unsuccessful in six patients. Six children are still under EBD and 13 are lost to follow-up. The overall success rate was 92%. The age at the time of first dilatation was the youngest in OA group followed by corrosive strictures. The balloon sizes differed regarding the age of the patients with larger balloons used as the patient age increased. The sizes of the balloons used at the first and the last EBD differed among diagnostic groups. The total number of dilatations or the time interval between the first and the last EBD dilatation did not show a statistically significant difference among groups. The anatomical type of OA or the height of corrosive stricture revealed no significant difference in any of the above parameters. A transmural oesophageal perforation occurred during 2 (0.4%) EBD sessions.

CONCLUSIONS

EBD is an effective mean in relieving paediatric oesophageal pathologies with a variety of aetiologies and has a low complication rate.

摘要

背景

对于儿童不同病因的食管扩张,可通过探条或球囊进行。我们研究了由一名外科医生实施的内镜下球囊扩张术(EBD)的疗效和安全性。

患者与方法

在伦理委员会批准下,对12年期间的相关数据进行回顾性评估。

结果

97名儿童接受了514次EBD,EBD次数中位数为3次(1 - 50次)。主要诊断包括51名儿童的食管闭锁(OA)、21名儿童的腐蚀性吞入、13名儿童的消化性狭窄、8名儿童的贲门失弛缓症以及4名儿童的先天性食管狭窄。球囊大小在3至30毫米之间。72例患者的EBD成功完成,6例患者失败。6名儿童仍在接受EBD治疗,13名儿童失访。总体成功率为92%。首次扩张时的年龄在OA组最小,其次是腐蚀性狭窄组。球囊大小因患者年龄而异,随着患者年龄增加使用更大的球囊。首次和末次EBD使用的球囊大小在各诊断组之间存在差异。扩张总次数或首次与末次EBD扩张之间的时间间隔在各组之间未显示出统计学上的显著差异。OA的解剖类型或腐蚀性狭窄的高度在上述任何参数中均未显示出显著差异。在2次(0.4%)EBD操作过程中发生了透壁性食管穿孔。

结论

EBD是缓解多种病因引起的小儿食管病变的有效方法,且并发症发生率低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c68/10034793/32367d5fcd81/JMAS-19-62-g001.jpg

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