title: The Efficacy of Intralesional Steroid Injection in the Treatment of Corrosive Esophageal Strictures in Children.
abstract: OBJECTIVE
  Esophageal dilatation can be insufficient in the treatment of severe corrosive esophageal strictures. In this study, we aimed to present the efficacy of intralesional steroid injection as an adjunct to dilatation therapy.
  
  
  METHODS
  Retrospective analysis of children who underwent intralesional steroid injection between 2004 and 2014 was performed. Patients' age, type of corrosive substance, length of stricture, number of injection and dilatation sessions and complications were reviewed. The success was evaluated by the comparison of number, frequency, and requirement of dilatation therapy before and after injection.
  
  
  RESULTS
  Intralesional steroid injection was performed to 32 children with a mean age of 3.6±2.5 years. The types of corrosive agents were alkali (24) or acid (8). Mean number of injection sessions was 2.5±1.1(1 to 6). Mean number of dilatation sessions was decreased from 10±8.8 to 5.4±4.6 after injection (P=0.003). Mean frequency of dilatations was extended from 3.6±0.9 weeks to 8.7±3.9 weeks (P=0.000). Dilatation treatment was successfully terminated in 25 of 27 children with short-segment strictures after injection (92%). Whereas all of the children with long-segment strictures could not resolved and finally required esophageal replacement (5 patients). One patient had transient cushingoid phenotype as a complication. There was not seen any major complication-like perforation. The mean follow-up period was 6±3 years.
  
  
  CONCLUSIONS
  Intralesional steroid injection is an effective adjunct to dilatation in most of the children with short-segment strictures. It should be performed as a safe and efficient treatment option in patients with short-segment corrosive esophageal strictures resistant to dilatation therapy.
authors.affiliation: Department of Pediatric Surgery, Ege University Faculty of Medicine, İzmir, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Divarci
authors.forename: Ulgen
authors.initials: U
authors.lastname: Celtik
authors.forename: Zafer
authors.initials: Z
authors.lastname: Dokumcu
authors.forename: Coskun
authors.initials: C
authors.lastname: Ozcan
authors.forename: Ata
authors.initials: A
authors.lastname: Erdener
mesh_terms: D000143:Acids / Q000009:adverse effects; D000468:Alkalies / Q000009:adverse effects; D002675:Child, Preschool; D004940:Esophageal Stenosis / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000143:Acids; D000468:Alkalies; D005938:Glucocorticoids