title: Endoscopic Incision for the Treatment of Refractory Esophageal Anastomotic Strictures in Children.
abstract: OBJECTIVE
  The aim of the present study was to assess the safety and efficacy of endoscopic incision (EI) for the treatment of refractory anastomotic esophageal strictures in pediatric patients.
  
  
  METHODS
  We retrospectively reviewed the medical records of pediatric patients with refractory anastomotic strictures after surgical repair of esophageal atresia who underwent ≥3 sessions of endoscopic treatments (dilation and/or stenting). They were treated with EI alone or together with esophageal stenting. Efficacy and safety were evaluated during periodical follow-up.
  
  
  RESULTS
  All of the 7 children received the procedure successfully with the operation time of 15 to 60 minutes. Four of them received EI alone, whereas the other 3 received EI with esophageal stenting (EIES). The symptoms remitted in all of the patients, and the dysphagia score decreased from 3-4 to 0-1 during follow-up from 1 to 21 months. The average diameter of stricture was enlarged from 3 mm (range 2-5 mm) to 10.6 mm (range 8-12 mm). One patient suffered from chest pain, which resolved within 3 days. Patient 1 had recurrence 11 months after EIES, and patient 6 had recurrence 3 months after EI. They all underwent an additional EI to maintain patency. No severe complications were observed during operation and periodical follow-up.
  
  
  CONCLUSIONS
  EI is safe and appears effective for refractory esophageal anastomotic strictures in children in the short term. Large comparative studies are warranted to further confirm our findings. The long-term follow-up is necessary for assessing the long-term efficacy of the new technique.
authors.affiliation: Department of Gastroenterology, Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
authors.forename: Yuyong
authors.initials: Y
authors.lastname: Tan
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.forename: Junfeng
authors.initials: J
authors.lastname: Zhou
authors.forename: Tianying
authors.initials: T
authors.lastname: Duan
authors.forename: Deliang
authors.initials: D
authors.lastname: Liu
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery; D004933:Esophageal Atresia / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D061646:Operative Time; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome