Evaluation von Stents zur Behandlung der benignen Osophagusstenose im Kindesalter

TY - JOUR

T1 - Evaluation von Stents zur Behandlung der benignen Osophagusstenose im Kindesalter

AU - Reinshagen, K

AU - Kähler, G

AU - Manegold, B C

AU - Waag, K-L

PY - 2008/2/8

Y1 - 2008/2/8

N2 - BACKGROUND: Esophageal stenting is a popular of treatment of esophageal strictures in adults. It has also been described for children with benign strictures who did not respond to standard dilatation therapy. The aim of the study was to evaluate weather esophageal stents could be used safely and effectively in the treatment of benign esophageal strictures in children.PATIENTS: From 1993 to 2005 stenting therapy was performed in 12 children with complicated esophageal strictures. Etiologies of the strictures were caustic burns in 9 patients, postoperative strictures due to complicated esophageal atresia in 2 patients and iatrogenic esophageal injury in 1 patient.METHOD: Esophageal silicon tubi, covered retrievable expandable nitinol and plastic stents were placed endoscopically. The clinical course and the long term follow up were evaluated retrospectivelyRESULTS: The stents and tubi were placed in all patients without complications and were later removed successfully. 6 patients were treated with a self expanding plastic stent. The plastic stents showed a distinct tendency to migrate but in 5/6 patients esophageal stricture was treated successfully. 3 patients were treated by a covered self expanding nitinol stent. No migration occurred. One patient was asymptomatic after therapy, one required further dilatation therapy and the third had esophageal resection. 3 patients were treated by esophageal tubi. 2 patients required surgery in the follow up, one patient is asymptomatic.CONCLUSION: The use of stenting devices in children to treat benign esophageal strictures is safe and efficient. The self expanding plastic stents had the best long term results but required high compliance of parents and children due to the tendency of stent migration. Self expanding nitinol stents are more traumatic at the extraction procedure and are useful in patients with low compliance. Recurrence of strictures occurred most often after esophageal tubi possibly due to the lack of radial expansion.

AB - BACKGROUND: Esophageal stenting is a popular of treatment of esophageal strictures in adults. It has also been described for children with benign strictures who did not respond to standard dilatation therapy. The aim of the study was to evaluate weather esophageal stents could be used safely and effectively in the treatment of benign esophageal strictures in children.PATIENTS: From 1993 to 2005 stenting therapy was performed in 12 children with complicated esophageal strictures. Etiologies of the strictures were caustic burns in 9 patients, postoperative strictures due to complicated esophageal atresia in 2 patients and iatrogenic esophageal injury in 1 patient.METHOD: Esophageal silicon tubi, covered retrievable expandable nitinol and plastic stents were placed endoscopically. The clinical course and the long term follow up were evaluated retrospectivelyRESULTS: The stents and tubi were placed in all patients without complications and were later removed successfully. 6 patients were treated with a self expanding plastic stent. The plastic stents showed a distinct tendency to migrate but in 5/6 patients esophageal stricture was treated successfully. 3 patients were treated by a covered self expanding nitinol stent. No migration occurred. One patient was asymptomatic after therapy, one required further dilatation therapy and the third had esophageal resection. 3 patients were treated by esophageal tubi. 2 patients required surgery in the follow up, one patient is asymptomatic.CONCLUSION: The use of stenting devices in children to treat benign esophageal strictures is safe and efficient. The self expanding plastic stents had the best long term results but required high compliance of parents and children due to the tendency of stent migration. Self expanding nitinol stents are more traumatic at the extraction procedure and are useful in patients with low compliance. Recurrence of strictures occurred most often after esophageal tubi possibly due to the lack of radial expansion.

KW - Alloys

KW - Burns, Chemical

KW - Child

KW - Child, Preschool

KW - Esophageal Stenosis

KW - Esophagoscopy

KW - Follow-Up Studies

KW - Humans

KW - Patient Compliance

KW - Recurrence

KW - Silicones

KW - Stents

KW - Time Factors

KW - Treatment Outcome

KW - Comparative Study

KW - Evaluation Studies

KW - Journal Article

U2 - 10.1055/s-2007-984377

DO - 10.1055/s-2007-984377

M3 - SCORING: Zeitschriftenaufsatz

C2 - 18256979

VL - 221

SP - 25

EP - 30

JO - KLIN PADIATR

JF - KLIN PADIATR

SN - 0300-8630

IS - 1

ER -