title: Endoscopic management of esophageal stenosis in children: New and traditional treatments.
abstract: Post-esophageal atresia anastomotic strictures and post-corrosive esophagitis are the most frequent types of cicatricial esophageal stricture. Congenital esophageal stenosis has been reported to be a rare but typical disease in children; other pediatric conditions are peptic, eosinophilic esophagitis and dystrophic recessive epidermolysis bullosa strictures. The conservative treatment of esophageal stenosis and strictures (ES) rather than surgery is a well-known strategy for children. Before planning esophageal dilation, the esophageal morphology should be assessed in detail for its length, aspect, number and level, and different conservative strategies should be chosen accordingly. Endoscopic dilators and techniques that involve different adjuvant treatment strategies have been reported and depend on the stricture's etiology, the availability of different tools and the operator's experience and preferences. Balloon and semirigid dilators are the most frequently used tools. No high-quality studies have reported on the differences in the efficacies and rates of complications associated with these two types of dilators. There is no consensus in the literature regarding the frequency of dilations or the diameter that should be achieved. The use of adjuvant treatments has been reported in cases of recalcitrant stenosis or strictures with evidence of dysphagic symptoms. Corticosteroids (either systemically or locally injected), the local application of mitomycin C, diathermy and laser ES sectioning have been reported. Some authors have suggested that stenting can reduce both the number of dilations and the treatment length. In many cases, this strategy is effective when either metallic or plastic stents are utilized. Treatment complications, such esophageal perforations, can be conservatively managed, considering surgery only in cases with severe pleural cavity involvement. In cases of stricture relapse, even if such relapses occur following the execution of well-conducted conservative strategies, surgical stricture resection and anastomosis or esophageal substitution are the only remaining options.
authors.affiliation: Luigi Dall'Oglio, Tamara Caldaro, Francesca Foschia, Simona Faraci, Giovanni Federici di Abriola, Francesca Rea, Erminia Romeo, Filippo Torroni, Giulia Angelino, Paola De Angelis, Digestive Endoscopy and Surgery Unit, Bambino Gesù Children Hospital, IRCCS, 00165 Roma, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Dall'Oglio
authors.affiliation: Luigi Dall'Oglio, Tamara Caldaro, Francesca Foschia, Simona Faraci, Giovanni Federici di Abriola, Francesca Rea, Erminia Romeo, Filippo Torroni, Giulia Angelino, Paola De Angelis, Digestive Endoscopy and Surgery Unit, Bambino Gesù Children Hospital, IRCCS, 00165 Roma, Italy.
authors.forename: Tamara
authors.initials: T
authors.lastname: Caldaro
authors.affiliation: Luigi Dall'Oglio, Tamara Caldaro, Francesca Foschia, Simona Faraci, Giovanni Federici di Abriola, Francesca Rea, Erminia Romeo, Filippo Torroni, Giulia Angelino, Paola De Angelis, Digestive Endoscopy and Surgery Unit, Bambino Gesù Children Hospital, IRCCS, 00165 Roma, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Foschia
authors.affiliation: Luigi Dall'Oglio, Tamara Caldaro, Francesca Foschia, Simona Faraci, Giovanni Federici di Abriola, Francesca Rea, Erminia Romeo, Filippo Torroni, Giulia Angelino, Paola De Angelis, Digestive Endoscopy and Surgery Unit, Bambino Gesù Children Hospital, IRCCS, 00165 Roma, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Faraci
authors.affiliation: Luigi Dall'Oglio, Tamara Caldaro, Francesca Foschia, Simona Faraci, Giovanni Federici di Abriola, Francesca Rea, Erminia Romeo, Filippo Torroni, Giulia Angelino, Paola De Angelis, Digestive Endoscopy and Surgery Unit, Bambino Gesù Children Hospital, IRCCS, 00165 Roma, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Federici di Abriola
authors.affiliation: Luigi Dall'Oglio, Tamara Caldaro, Francesca Foschia, Simona Faraci, Giovanni Federici di Abriola, Francesca Rea, Erminia Romeo, Filippo Torroni, Giulia Angelino, Paola De Angelis, Digestive Endoscopy and Surgery Unit, Bambino Gesù Children Hospital, IRCCS, 00165 Roma, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Rea
authors.affiliation: Luigi Dall'Oglio, Tamara Caldaro, Francesca Foschia, Simona Faraci, Giovanni Federici di Abriola, Francesca Rea, Erminia Romeo, Filippo Torroni, Giulia Angelino, Paola De Angelis, Digestive Endoscopy and Surgery Unit, Bambino Gesù Children Hospital, IRCCS, 00165 Roma, Italy.
authors.forename: Erminia
authors.initials: E
authors.lastname: Romeo
authors.affiliation: Luigi Dall'Oglio, Tamara Caldaro, Francesca Foschia, Simona Faraci, Giovanni Federici di Abriola, Francesca Rea, Erminia Romeo, Filippo Torroni, Giulia Angelino, Paola De Angelis, Digestive Endoscopy and Surgery Unit, Bambino Gesù Children Hospital, IRCCS, 00165 Roma, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Torroni
authors.affiliation: Luigi Dall'Oglio, Tamara Caldaro, Francesca Foschia, Simona Faraci, Giovanni Federici di Abriola, Francesca Rea, Erminia Romeo, Filippo Torroni, Giulia Angelino, Paola De Angelis, Digestive Endoscopy and Surgery Unit, Bambino Gesù Children Hospital, IRCCS, 00165 Roma, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Angelino
authors.affiliation: Luigi Dall'Oglio, Tamara Caldaro, Francesca Foschia, Simona Faraci, Giovanni Federici di Abriola, Francesca Rea, Erminia Romeo, Filippo Torroni, Giulia Angelino, Paola De Angelis, Digestive Endoscopy and Surgery Unit, Bambino Gesù Children Hospital, IRCCS, 00165 Roma, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: De Angelis
keywords: Caustic stricture; Esophageal dilation; Esophageal stenosis; Esophageal stent; Esophageal stricture