title: Endoscopic management for congenital esophageal stenosis: A systematic review.
abstract: Congenital esophageal stenosis (CES) is an extremely rare malformation, and standard treatment have not been completely established. By years of clinical research, evidence has been accumulated. We conducted systematic review to assess outcomes of the treatment for CES, especially the role of endoscopic modalities. A total of 144 literatures were screened and reviewed. CES was categorized in fibromuscular thickening, tracheobronchial remnants (TBR) and membranous web, and the frequency was 54%, 30% and 16%, respectively. Therapeutic option includes surgery and dilatation, and surgery tends to be reserved for ineffective dilatation. An essential point is that dilatation for TBR type of CES has low success rate and high rate of perforation. TBR can be distinguished by using endoscopic ultrasonography (EUS). Overall success rate of dilatation for CES with or without case selection by using EUS was 90% and 29%, respectively. Overall rate of perforation with or without case selection was 7% and 24%, respectively. By case selection using EUS, high success rate with low rate of perforation could be achieved. In conclusion, endoscopic dilatation has been established as a primary therapy for CES except TBR type. Repetitive dilatation with gradual step-up might be one of safe ways to minimize the risk of perforation.
authors: Keita Terui, Takeshi Saito, Tetsuya Mitsunaga, Mitsuyuki Nakata, Hideo Yoshida, Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8677, Japan.
authors: Keita
authors: K
authors: Terui
authors: Keita Terui, Takeshi Saito, Tetsuya Mitsunaga, Mitsuyuki Nakata, Hideo Yoshida, Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8677, Japan.
authors: Takeshi
authors: T
authors: Saito
authors: Keita Terui, Takeshi Saito, Tetsuya Mitsunaga, Mitsuyuki Nakata, Hideo Yoshida, Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8677, Japan.
authors: Tetsuya
authors: T
authors: Mitsunaga
authors: Keita Terui, Takeshi Saito, Tetsuya Mitsunaga, Mitsuyuki Nakata, Hideo Yoshida, Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8677, Japan.
authors: Mitsuyuki
authors: M
authors: Nakata
authors: Keita Terui, Takeshi Saito, Tetsuya Mitsunaga, Mitsuyuki Nakata, Hideo Yoshida, Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8677, Japan.
authors: Hideo
authors: H
authors: Yoshida
keywords: Deglutition disorders; Dilatation; Endosonography; Esophageal atresia; Esophageal perforation; Esophageal ring; Esophageal stenosis; Esophagoscopes; Plummer-Vinson syndrome; Tracheoesophageal fistula