O Baghdadi et al. JPGN 2022; 74: 221-226. Predictors and Outcomes of Fully Covered Stent Treatment for Anastomotic Esophageal Strictures in Esophageal Atresia
This retrospective review of 45 patients (n=92 stents) examine the effectiveness of esophageal stenting in patients with esophageal atresia (EA). All patients had multiple dilatations prior to stenting and/or had a stricture diameter that rapidly narrowed within 2 weeks of dilatation to a diameter that was the same or smaller to predilatation. Patients were observed in the hospital after stent placement and outpatient management was considered if oral nutrition was tolerated for at least 3 days.
- According to the authors, the stents prevented surgical resection in 41% of patients
- ΔD (change in diameter) of ≤4 mm (area under the curve = 0.790; 95% confidence interval: 0.655–0.924; P < 0.001) was the optimal cutoff point in differentiating stent success. If the change in diameter decreases by 4 mm or more after stent removal at endoscopic followup, it is likely that stricture contains significant scar tissue and is not amenable to dilatation/stenting.
- Median stent duration was 11.5 days
- The most common adverse events were erosions/ulcerations (29%), granulation tissue formation (27%), vomiting/retching (26%) and stent migration (9%). Three stents were complicated by an esophageal leak (treated medically).
My take: Complications were frequent; thus, stenting for refractory strictures requires highly-specialized technical expertise.
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- Guidelines for esophageal atresia-TEF
- More Often Than Not Esophagitis after EA Repair is not due to Reflux
- How Long Should Be PPIs Be Used in Patients with Esophageal Atresia?
- Esophageal Diseases Special ~15% of Healthy Individuals have microscopic esophagitis
- Esophagitis in Pediatric Esophageal Atresia
- Increased Risk of Eosinophilic Esophagitis with Esophageal Atresia
- Never quite right | gutsandgrowth,
- Endoscopic Surveillance after Esophageal Atresia: Low Yield in Pediatrics