title: Custom dynamic stent for esophageal strictures in children.
abstract: BACKGROUND
  Esophageal stenting represents a new strategy to avoid multiple dilations owing to stenosis relapse. Our custom stent improves esophageal motility unlike the widespread self-expandable plastic esophageal stents. The aim of the study was to confirm the efficacy of treatment with silicone custom stents in esophageal stenosis (ES) in pediatric patients.
  
  
  METHODS
  A silicone stent of 7-, 9-, or 12.7-mm external diameter is built coaxially on a nasogastric tube that guarantees the correct position. The 2 ends are tailored to allow food passage between stent and esophageal wall. All patients received dexamethasone (2 mg/kg per day) for 3 days and ranitidine/proton-pump inhibitors. Study approval was obtained from our ethical board.
  
  
  RESULTS
  From 1988 to 2010, 79 patients with ES, mean age 35.4 months (3-125 months), underwent esophageal hydrostatic/Savary dilations and custom-stent placement, left in place for at least 40 days. Stenting was effective in 70 (88.6%) of 79 patients. Fifty percent of the patients with effective treatment received only one dilation for stent placement. Fourteen patients received more stents successfully. There was one stent-related major complication.
  
  
  CONCLUSIONS
  Our custom stent improves treatment in ES. In caustic injuries, ES stenting represents the first option. In postsurgical ES, we stent after at least 5 dilations.
authors: Digestive Surgery and Endoscopy Unit, Bambino Gesù Hospital, 00165 Rome, Italy. francesca.foschia@libero.it
authors: Francesca
authors: F
authors: Foschia
authors: Paola
authors: P
authors: De Angelis
authors: Filippo
authors: F
authors: Torroni
authors: Erminia
authors: E
authors: Romeo
authors: Tamara
authors: T
authors: Caldaro
authors: Giovanni Federici
authors: GF
authors: di Abriola
authors: Alessandro
authors: A
authors: Pane
authors: Maria Stella
authors: MS
authors: Fiorenza
authors: Francesco
authors: F
authors: De Peppo
authors: Luigi
authors: L
authors: Dall'Oglio