Oesophageal replacement in children with indolent stricture of the oesophagus.
OBJECTIVE
To evaluate the indications for and results of oesophageal replacement for acquired oesophageal stricture in children.


METHODS
This was a descriptive interventional study. Between 1987 and 2003, patients who had peptic or corrosive stricture were included in the study. Age and gender were analysed and any history of ingestion of caustic agents or untreated reflux was noted. Types of symptoms such as progressive dysphagia to solids and liquids and extent of respiratory infections were evaluated. Nutritional deprivation was also measured. Success or failure of dilatation at the time of endoscopy was taken into account. The criterion for oesophageal replacement was recurrence of stricture within 3 weeks of the previous dilatation. Patients were prepared with general supportive care. Feeding gastrostomy was performed in 12 patients who were severely malnourished. No patients underwent oesophagectomy of the strictured oesophagus. Short- and long-term complications were recorded.


RESULTS
Of the 54 patients, 34 were male and 20 were female. Colonic conduit and reverse gastric tube were used in 27 patients each. Three patients had leak and were treated conservatively. Six patients developed anastomotic stricture but benefited remarkably from periodic dilatation and, in the long-term, remained symptom-free. Results were generally very gratifying.


CONCLUSIONS
Most patients who require oesophageal conduit do well and catch up with their growth and development.
ul-Haq
Anwar
A
Department of Pediatric Surgery, The Children Hospital, Pakistan Institute of Medical Sciences, 17-B Mehran Block, Gulshan-e-Jinnah, F-5/1 Islamabad, Pakistan. drahaq@hotmail.com
Tareen
Farhan
F
Bader
Ilyas
I
Burki
Tariq
T
Khan
Naeem-uz-Zafar
NU
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004940:Esophageal Stenosis / Q000601:surgery*; D004944:Esophagoplasty / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016896:Treatment Outcome