Department of Pediatrics, School of Medicine, Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Dysphagia. 2023 Jun;38(3):744-755. doi: 10.1007/s00455-022-10511-8. Epub 2022 Aug 30.
Little is known about the efficacy and safety of esophageal stents for the management of esophageal strictures in children and adolescents. A systematic review was performed to assess the efficacy and safety of esophageal stents for the management of benign esophageal strictures in children and adolescents. Observational studies related to the examination of esophageal stents in pediatrics were extracted using the original databases by December 2021. We found 18 retrospective and prospective studies with a total of 340 children and adolescents. Overall, our findings show that different therapeutic modalities based on esophageal stents were offered to children and adolescents for various indications, in which most studies reported successful cases, although ineffective claims cannot be ignored. Fully covered self-expandable metal stent, self-expandable metal stent, and silastic esophageal stent were the stent types most used, although different materials and prototypes were reported as well. The number of stents used per patient and the duration of the stenting therapy varied widely (ranging from 1 to 584 days). Such treatments were not standardized because of different factors, such as different tolerance to complications in subjects aged 1 month and 16 years, frequent stent migration requiring removal followed or not by its replacement, different guides provided by each stent manufacturer, and successful healing of esophageal lesions. Different esophageal stents may be a reasonable therapeutic approach for the management of benign esophageal strictures in children and adolescents. We believe that esophagus-sparing methods like stents represent a promising alternative or adjunctive treatment to be considered in pediatrics.
关于食管支架治疗儿童和青少年食管狭窄的疗效和安全性知之甚少。本系统评价旨在评估食管支架治疗儿童和青少年良性食管狭窄的疗效和安全性。通过原始数据库,检索了截至 2021 年 12 月与儿科食管支架检查相关的观察性研究。我们共纳入了 18 项回顾性和前瞻性研究,共 340 名儿童和青少年。总的来说,我们的研究结果表明,不同的治疗方法基于食管支架为各种适应症提供给儿童和青少年,尽管不能忽视无效的说法,但大多数研究报告了成功的病例。完全覆膜自膨式金属支架、自膨式金属支架和硅酮食管支架是最常使用的支架类型,尽管也有报道使用不同的材料和原型。每个患者使用的支架数量和支架治疗的持续时间差异很大(1 至 584 天)。由于不同的因素,如 1 个月和 16 岁患者对并发症的不同耐受程度、频繁需要移除支架且随后是否更换、每个支架制造商提供的不同引导以及食管病变的成功愈合,这些治疗方法没有标准化。不同的食管支架可能是治疗儿童和青少年良性食管狭窄的合理治疗方法。我们相信,像支架这样的食管保留方法代表了一种有前途的替代或辅助治疗方法,值得在儿科领域考虑。