A Single Center Experience of Self-Bougienage on Stricture Recurrence after Surgery for Corrosive Esophageal Strictures in Children

다국어 초록 (Multilingual Abstract)

Purpose: This study was undertaken to evaluate the long-term treatment of esophageal strictures in children with corrosive esophagitis and to determine the effect of self-bougienage on recurrent strictures. Materials and Methods: We reviewed the medical records of nine children that were treated for corrosive esophageal strictures from May 2000 to May 2008. Six males and three females were included and their average age was 30 months. Six patients had ingested acids, two patents had ingested alkali, and one ingested an unknown agent. Results: The interval between caustic ingestion and esophageal stricture ranged from one to eight weeks. The average length of the esophageal strictures was 3.8 cm (range, 1 to 9.2 cm). Four patients had a long segment stricture (longer than 5cm) and one patient had multiple strictures. The most common site of involvement was the upper third followed by the mid third of the esophagus. Eight patients received repeated dilatation using a balloon catheter or bougie dilator.
Among the eight patients, two patients had complete resolution of symptoms and six patients required surgery.
Among five patients that developed restenosis of the esophageal anastomosis site, three patients had improved symptoms after self-bougienage and two patients had improved symptoms with repeated balloon dilatation or endoscopic bougienage. There were no complications in these patients. Conclusion: Although a small number of patients were studied, self-bougienage was safe, less invasive, and effective for the management of esophageal restenosis in patients who required frequent dilation after surgery.

참고문헌 (Reference)

1 Han Y, "Surgical management of esophageal strictures after caustic burns: a 30 years of experience" 10 : 2846-2849, 2004

2 Grobe JL, "Self-bougienage in the treatment of benign esophageal stricture" 6 : 109-112, 1984

3 Kim CH, "Recurrent benign esophageal strictures treated with self-bougienage: report of seven cases" 65 : 799-803, 1990

4 Gilmore IT, "Oesophageal self-bougienage" 1 : 620-621, 1982

5 Arévalo-Silva C, "Ingestion of caustic substances: a 15-year experience" 116 : 1422-1426, 2006

6 Ferguson DD, "Evaluation and management of benign esophageal strictures" 18 : 359-364, 2005

7 Genç A, "Esophageal motility changes in acute and late periods of caustic esophageal burns and their relation to prognosis in children" 37 : 1526-1528, 2002

8 Gün F, "Early and late term management in caustic ingestion in children: a 16-year experience" 107 : 49-52, 2007

9 Gündoǧdu HZ, "Conservative treatment of caustic esophageal strictures in children" 27 : 767-770, 1992

10 Kruger FC, "Caustic injury to the upper GI tract" 59 : 335-, 2004

11 Doǧan Y, "Caustic gastroesophageal lesions in childhood: an analysis of 473 cases" 45 : 435-438, 2006