title: Indwelling esophageal balloon catheter for benign esophageal stenosis in infants and children.
abstract: BACKGROUND
  Balloon dilatation of benign esophageal strictures is an established mode of therapy in adults and children. There remains a group of patients with refractory stenosis despite dilatation at regular intervals. An indwelling balloon catheter may offer an alternative.
  
  
  METHODS
  This is a retrospective study of 19 children who underwent esophagoscopy between 2004 and 2012 with placement of an indwelling balloon catheter for refractory esophageal stenosis. Total number of endoscopies, number of endoscopies with indwelling balloon catheter, as well as complications, reoperations, and mortality due to use of the balloon catheter were studied.
  
  
  RESULTS
  Patient age ranged from 4 weeks to 15 years. The indwelling balloon catheter was used to treat refractory stenosis after corrective surgery of long gap esophageal atresia (n = 5), esophageal atresia with distal fistula (n = 2), refractory esophageal stenosis due to caustic esophageal burns (n = 7), reflux (n = 2), and stenosis of unknown cause (n = 3). With the indwelling balloon catheter in place, the mean number of endoscopies equalled four. Complications were restenosis after a symptom-free period for which a new indwelling balloon catheter was necessary (n = 3). Two others needed two to five additional dilations: balloon leakage requiring replacement (n = 7 in 5 patients), sputum retention (n = 1), and dislodgement (n = 5 in 4 patients). More importantly, there was no mortality or the need for any patient to undergo a surgical resection.
  
  
  CONCLUSIONS
  The indwelling balloon catheter is safe to use and can be used by parents at home. More importantly it obviates the need for rethoracotomy/-scopy or esophageal replacement.
authors.affiliation: Department of Pediatric Surgery KE.04.140.5, Wilhelmina Children's Hospital, University Medical Centre Utrecht, P.O. Box 85090, 3508 AB, Utrecht, The Netherlands, d.c.vanderzee@umcutrecht.nl.
authors.forename: David
authors.initials: D
authors.lastname: van der Zee
authors.forename: Caroline
authors.initials: C
authors.lastname: Hulsker
mesh_terms: D000293:Adolescent; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D004106:Dilatation / Q000295:instrumentation*; D004940:Esophageal Stenosis / Q000175:diagnosis / Q000628:therapy*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome