Characteristic analysis and efficacy evaluation of bougie dilation and bougie dilation combined with stent implantation for pediatric caustic esophageal stenosis
10.3760/cma.j.cn321463-20201207-00460
- VernacularTitle:探条扩张或扩张联合支架置入术治疗小儿化学烧伤性食管狭窄的特征分析及效果评价
- Author:
Yufen TANG
1
;
Yuqi HE
;
Yida E
;
Hui XIE
;
Jianqiu SHENG
Author Information
1. 解放军总医院第一医学中心消化内科医学部第七医学中心消化内科，北京 100853
- Keywords:
Burns, chemical;
Esophageal stenosis;
Stents;
Bougie dilatation;
Effectiveness
- From:
Chinese Journal of Digestive Endoscopy
2022;39(3):235-238
- CountryChina
- Language:Chinese
-
Abstract:
To investigate the efficacy and safety of endoscopic bougie dilation and stent implantation for pediatric caustic esophageal stenosis. Clinical characteristics, diagnosis and treatment of children with pediatric caustic esophageal stenosis from October 2009 to December 2019 at Department of Gastroenterology, the Seventh Medical Center of PLA General Hospital were retrospectively analyzed. A total of 50 caustic esophageal stenosis cases were enrolled, among whom, 94.0% (47/50) received conservative treatment before sending to our hospital. Thirty-six (72.0%) of them accidently ingested caustic substance of alkali and 22.0% (11/50) of them accidently ingested caustic substance of acid. Forty-six children (92.0%) who ingested caustic agents were younger than 7 years old. The stenosis was more common in the upper esophagus, accounting for 64.0% (32/50). Twenty-seven cases (54.0%) underwent simple bougie dilation and 16 cases (32.0%) underwent bougie dilation combined with stent treatment. All 50 children underwent a total of 1 260 expansions. The numbers of simple dilations and dilations combined with stent implantation were 37.8±26.2, 20.9±12.6 respectively with significant difference ( t=2.453, P=0.021). Among them, 2 cases (4.0%) underwent surgery, 5 cases (10.0%) underwent surgery combined with dilatation and stent implantation. The stenosis diameter widened significantly after treatment (1.1±0.2 cm VS 0.2±0.1 cm, t=23.004, P<0.001), and the Stooler grade of dysphagia improved significantly (grade 3.5±0.5 VS 1.2±0.7, t=19.925, P<0.001). Perforation occurred in only 1 patient, who was cured by conservative treatment with stent implantation. The total effective rate was 100.0% (50/50) and the satisfaction rate was 98.0% (49/50). Endoscopic bougie dilation and bougie dilation combined with stent implantation is safe and effective for pediatric caustic esophageal stenosis. Combination with stent implantation can reduce the number of dilation times.
