Flexible endoscopy in esophageal strictures: Efficacy and reliability

Abstract

Aim: We evaluated the efficacy and the reliability of the flexible endoscopy in the diagnosis and treatment of benign esophageal strictures. Material and Method: Between February 2004 and April 2005, 23 patients with esophageal strictures and dilatation by flexible endoscopy were evaluated according to the age, sex, clinical and radiologic findings, surgical interventions and postoperative complications. During flexible esophagoscopy, a guidewire was advanced through the instrument channel of the esophagoscope, an anterior dilatator and/or a balloon catheter was advanced according to the Seldinger method to the distal esophagus. Under flouroscopic control, a dilatation was performed. Results: In 23 patients (mean age 1.5), we performed 66 esophageal dilatations. Fourteen patients had an esophageal atresia, 1 congenital esophageal stenosis, one achalasia, one GERD, three acid ingestion, 3 alkali ingestion. All of the patients experienced difficulties during feeding. The esophagographies of all patients showed strictures. In 19 cases, a balloon dilatation was performed and in 4 patients, both antegrade dilatator and balloon catheter dilatation were made. In one patient with a esophageal pseudodiverticulum, a self-limited perforation occured with spontaneous healing. No other complication was seen. In early postoperative follow up, the feeding was without any problem. Conclusion: The esophageal dilatation by means of flexible endoscopy is a safe and effective tool in children with benign esophagus strictures.