When Can Balloon Dilatation of an Oesophageal Stricture in Children be Considered
Successful?
Lisý J., Šnajdauf J., Šimonová M., Heroldová D., Vyhnánek M., Rygl M., Zeman L., Tůma S., Neuwirth J.:
Klinika zobrazovacích metod 2. LF UK a FN v Motole, Praha, přednosta doc. MUDr. J. Neuwirth, CSc. Klinika dětské chirurgie, Subkatedra dětské chirurgie IPVZ 2. LF UK a FN v Motole, Praha, přednosta prof. MUDr. J. Šnajdauf, CSc. |
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Summary:
Cicatrization of a stricture after its balloon dilatation leads to renewed narrowing of the oesopha-
geal lumen and a relapse of dysphagia. Subsequently repeated dilatations are called for. The authors
tried to establish after what time interval it may be said that the dilatation is a success and further
dilatation or surgery is not necessary.
Oesophageal stricture was in 49 children (20 girls and 29 boys) treated by 194 balloon dilatations.
A stricture in the anastomosis after surgery of oesophageal atresia was present in 20 children, 12
had a reflux stricture on GER, 6 a narrow cuff after Nissen’s fundoplication on account of achalasia,
6 a stricture after caustic damage of the oesophagus, 4 an inborn stenosis and 1 a stricture after
irradiation. The dilatation was successful, if, one year after the last dilatation, the patient did not
suffer from dysphagia and did not require surgery.
The authors included in the evaluation patients after repeated dilatations, i.e. at least two. 37
patients had repeated dilatations (75.5%). One dilatation only was sufficient to resolve complaints
in 12 patients (24.5%). None had to be operated. The interval between dilatations of oesophageal
strictures in repeated dilatations was from one week to three years. Of these 37 patients 11 patients
(29.7%) had to be operated. The longest interval between dilatations, when failure of dilatations
called for surgery, was 6 months. The authors assume that a 1-year interval from the last dilatation
without a relapse of dysphagia is sufficient for considering dilatation successful. A 6-month interval
after the last dilatation without dysphagia leads to the assumption that even in case of possible
dilatation the patient will not have to undergo surgery.
Key words:
oesophageal stricture - balloon dilatation - evaluation of successful dilatation
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