A clinical study of endoscopic balloon dilation in treatment of esophageal stenosis after neonatal esophageal atresia surgery

Objective To explore the feasibility and efficacy of endoscopic balloon dilation in treatment of esophageal stenosis caused by operation of congenital esophageal atresia. Methods A retrospective analysis was performed on data of 218 children with type Ⅲ esophageal atresia, who underwent surgery in Zhengzhou Children′s Hospital from January 2009 to December 2017. The occurrence of postoperative complications and efficacy of endoscopic balloon dilation in treatment of esophageal stenosis was analyzed. Results Among the 218 patients with congenital esophageal atresia, 92 were type Ⅲa and 126 were type Ⅲb. Postoperative anastomotic leakage occurred in 46 cases (21.1%), including 29 (31.5%) of type Ⅲa and 17 (13.5%) of type Ⅲb. Postoperative anastomotic stenosis occurred in 53 cases (24.3%), including 29 (31.5%) of type Ⅲa and 24 (19.0%) of type Ⅲb. The incidence of anastomotic leakage and anastomotic stenosis in different types was significantly different (χ2=10.383, P=0.001; χ2=4.497, P=0.034). The 53 cases of anastomotic stenosis underwent 123 times of endoscopic balloon dilation, with mean time of 3.5±1.6, and were finally clinically recovery. No esophagus perforation occurred. Among them, 29 cases of type Ⅲa underwent 73 times with mean of 4.0±1.8, and 24 cases of type Ⅲb underwent 50 times with mean of 2.5±0.7. The difference between the two types was statistically significant (t=-4.053, P=0.027). Conclusion Children with type Ⅲa esophageal atresia has a higher incidence of anastomotic stenosis and leakage, and more times of esophageal dilation. Endoscopic balloon dilation is safe and effective in treatment of esophageal stenosis after surgery for patients with congenital esophageal atresia. Key words: Child; Esophageal atresia; Esophageal stenosis; Endoscopic balloon dilation