title: Management of refractory esophageal stenosis in the pediatric age.
abstract: BACKGROUND
  Refractory esophageal stenosis (RES) is a major health problem in the pediatric population. Several techniques such as stent placement or C-mitomycin (CM) have been described as alternative treatments. We present our experience with both techniques, in our case with biodegradable stents (BS) and sometimes the association with stents and CM.
  
  
  METHODS
  Six patients have been included: 2 post-operative fistulas in patients with type I esophageal atresia; 1 operated atresia without fistula; and 3 caustic strictures. 5 BS were placed in 4 children: 3 of them in cases of atresia (2 prosthesis in one case) and the other one in a case of stricture. CM was used in 5 cases: in 2 of them from the beginning, and in the other 3 cases after failure of the stent.
  
  
  RESULTS
  When placed in fistulas, BS were fully covered. One of them successfully treated the fistula, but the other one was not effective. One stenosis was successfully treated with SB (in the case of persistent fistula), but recurrence was observed in the other 2 cases. One of these was solved with CM, and the other one needed a second stent. In the remaining 2 cases (one atresia and one caustic stricture) CM was effective after 1 and 2 sessions respectively. Overall, 5 out of 6 stenosis have been successfully treated (83.3%), and 1 out of 2 fistulas (50%).
  
  
  CONCLUSIONS
  Association of BS and CM has been effective in the management of RES in children.
authors.affiliation: Digestivo/Endoscopias, Hospital Clínico Universitario Virgen de la Arrixaca, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Alberca de Las Parras
authors.affiliation: Hospital Universitario Virgen de la Arrixaca. Murcia.
authors.forename: María
authors.initials: M
authors.lastname: Navalón Rubio
authors.affiliation: Hospital Universitario Virgen de la Arrixaca. Murcia.
authors.forename: Juan
authors.initials: J
authors.lastname: Egea Valenzuela
mesh_terms: D000293:Adolescent; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance; D004933:Esophageal Atresia / Q000150:complications / Q000601:surgery; D004937:Esophageal Fistula / Q000150:complications / Q000601:surgery; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use; D011183:Postoperative Complications / Q000628:therapy; D019919:Prosthesis Implantation; D015607:Stents
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin