Anastomotic stricture after surgical repair of esophageal atresia: frequency, risk factors, and efficacy of esophageal bougie dilatations

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• 作者：Lydia Serhal ; Fré ; dé ; ric Gottr ; Rony Sfeir ; Dominique Guimber ; Patrick Devos ; Michel Bonnevalle ; Laurent Storme ; Dominique Turck ; Laurent Michaud
• 关键词：Anastomotic stricture ; Esophageal atresia ; Bougie dilatations ; Endoscopy ; Children
• 刊名：Journal of Pediatric Surgery
• 出版年：2010
• 出版时间：July 2010
• 年：2010
• 卷：45
• 期：7
• 页码：1459-1462
• 全文大小：97 K

文摘

Aims

The aim of this study was to evaluate the frequency and risk factors of postoperative anastomotic stricture, and the efficacy and complications of esophageal bougie dilatations for symptomatic anastomotic stricture in a population of children with esophageal atresia.

Patients and Methods

The medical records of 62 children operated on for esophageal atresia type III (Ladd and Gross) over a 5-year period were retrospectively reviewed.

Results

Anastomotic stricture developed in 23 (37 % ) of patients. Anastomotic tension during primary repair of esophageal atresia was associated with subsequent stricture formation (P < .05). Patients required esophageal dilation at a mean age of 149 days (range, 30-600 days). Stricture resolution occurred after a mean of 3.2 dilatations per patient (range, 1-7). Dilation was successful in 87 % of patients. Three patients continued to present mild (n = 1) to severe (n = 2) dysphagia, mainly related to esophageal dysmotility. No complications were observed during or after the dilatation sessions.

Conclusions

Anastomotic stricture, secondary to the surgical treatment of esophageal atresia, remains a frequent complication in patients with esophageal atresia. Esophageal dilation with Savary-Gilliard bougies is a safe and effective procedure in the management of strictures.