title: Use of balloon dilatation for management of postoperative intestinal strictures in children with short bowel syndrome.
abstract: OBJECTIVE
  Children with short bowel syndrome (SBS) often require numerous operations to optimize intestinal function. Postoperative intestinal strictures are a complication that inhibits enteral feeding advancement and prolongs parenteral nutrition dependency, often requiring reoperation. Our objective was to review our experience with fluoroscopic balloon dilatation to treat intestinal strictures.
  
  
  METHODS
  A retrospective cohort study of intestinal failure patients with SBS was completed. Patients who had radiologically diagnosed intestinal strictures and treated with fluoroscopic guided balloon dilatation were included [n=6]. Data related to demographics, anatomy, surgical procedures, and dilatation procedures were collected. Descriptive summary statistics were employed.
  
  
  RESULTS
  98 intestinal failure patients were recruited between 2011 and 2015. Five of 98 patients (5.1%) [2 males; median age 4.4months] underwent fluoroscopy guided balloon dilatation of 6 strictures. Balloon dilatation was successful in 4/6 (67%). The median number of dilatations was 2 per patient (range=1-3). Median time to feed initiation postdilatation was 3days. One patient developed an anastomotic leak after dilatation that required antibiotics, but no reoperation.
  
  
  CONCLUSIONS
  Four of six (67%) postoperative bowel strictures in 5 patients with SBS were successfully treated with fluoroscopically guided balloon dilatation. Balloon dilatation is less invasive than reoperation, preserves bowel length and reduces time to reinitiation of enteral feeding.
  
  
  METHODS
  3.
authors.affiliation: Group for Improvement of Intestinal Function and Treatment (GIFT), The Hospital for Sick Children, Toronto, Canada.
authors.forename: Christina
authors.initials: C
authors.lastname: Belza
authors.affiliation: Group for Improvement of Intestinal Function and Treatment (GIFT), The Hospital for Sick Children, Toronto, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Fitzgerald
authors.affiliation: Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Joao
authors.initials: J
authors.lastname: Amaral
authors.affiliation: Group for Improvement of Intestinal Function and Treatment (GIFT), The Hospital for Sick Children, Toronto, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Steinberg
authors.affiliation: Group for Improvement of Intestinal Function and Treatment (GIFT), The Hospital for Sick Children, Toronto, Canada; Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Avitzur
authors.affiliation: Group for Improvement of Intestinal Function and Treatment (GIFT), The Hospital for Sick Children, Toronto, Canada; Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Canada. Electronic address: paul.wales@sickkids.ca.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Wales
mesh_terms: D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D004106:Dilatation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012778:Short Bowel Syndrome / Q000601:surgery*; D016896:Treatment Outcome
keywords: Balloon dilatation; Image guided therapy; Intestinal failure; Intestinal strictures; Pediatrics; Short bowel syndrome