Custom dynamic stent for esophageal strictures in children

Francesca Foschia, Paola De Angelis, Filippo Torroni, Erminia Romeo, Tamara Caldaro, Giovanni Federici Di Abriola, Alessandro Pane, Maria Stella Fiorenza, Francesco De Peppo, Luigi Dall'Oglio

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Esophageal stenting represents a new strategy to avoid multiple dilations owing to stenosis relapse. Our custom stent improves esophageal motility unlike the widespread self-expandable plastic esophageal stents. The aim of the study was to confirm the efficacy of treatment with silicone custom stents in esophageal stenosis (ES) in pediatric patients. Methods: A silicone stent of 7-, 9-, or 12.7-mm external diameter is built coaxially on a nasogastric tube that guarantees the correct position. The 2 ends are tailored to allow food passage between stent and esophageal wall. All patients received dexamethasone (2 mg/kg per day) for 3 days and ranitidine/proton-pump inhibitors. Study approval was obtained from our ethical board. Results: From 1988 to 2010, 79 patients with ES, mean age 35.4 months (3-125 months), underwent esophageal hydrostatic/Savary dilations and custom-stent placement, left in place for at least 40 days. Stenting was effective in 70 (88.6%) of 79 patients. Fifty percent of the patients with effective treatment received only one dilation for stent placement. Fourteen patients received more stents successfully. There was one stent-related major complication. Conclusion: Our custom stent improves treatment in ES. In caustic injuries, ES stenting represents the first option. In postsurgical ES, we stent after at least 5 dilations.

Original languageEnglish
Pages (from-to)848-853
Number of pages6
JournalJournal of Pediatric Surgery
Volume46
Issue number5
DOIs
Publication statusPublished - May 2011

Keywords

  • Dilations
  • Esophageal stenosis
  • Stenting

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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