Predictors of outcomes of endoscopic balloon dilatation in strictures after esophageal atresia repair: A retrospective study

Abstract

BACKGROUND Endoscopic balloon dilatation (EBD) has become the first line of therapy for benign esophageal strictures (ESs); however, there are few publications about the predictive factors for the outcomes of this treatment. AIM To assess the predictive factors for the outcomes of EBD treatment for strictures after esophageal atresia (EA) repair. METHODS Children with anastomotic ES after thoracoscopic esophageal atresia repair treated by EBD from January 2012 to December 2016 were included. All procedures were performed under tracheal intubation and intravenous anesthesia using a three-grade controlled radial expansion balloon with gastroscopy. Outcomes were recorded and predictors of the outcomes were analyzed. RESULTS A total of 64 patients were included in this analysis. The rates of response, complications, and recurrence were 96.77%, 8.06%, and 2.33%, respectively. The number of dilatation sessions and complications were significantly higher in patients with a smaller stricture diameter (P = 0.013 and 0.023, respectively) and with more than one stricture (P = 0.014 and 0.004, respectively). The length of the stricture was significantly associated with complications of EBD (P = 0.001). A longer interval between surgery and the first dilatation was related to more sessions and a poorer response (P = 0.017 and 0.024, respectively). CONCLUSION The diameter, length, and number of strictures are the most important predictive factors for the clinical outcomes of endoscopic balloon dilatation in pediatric ES. The interval between surgery and the first EBD is another factor affecting response and the number of sessions of dilatation.