Factors predicting successful endoscopic balloon dilatation of esophageal strictures in children - a retrospective study

Background: & Aims: Endoscopic balloon dilatation has become the first line treatment for benign esophageal strictures; It is important to know the factors predicting successful outcome to assist in selecting optimal protocol to obtain the best outcome and avoid as many complication as possible. This study aimed to assess the factors predicting outcome of endoscopic balloon dilatation treatment for esophageal stricture in children. Methods: All the patients with benign esophageal stricture treated by endoscopic balloon dilatation from January 2010 to December 2014 were included. All procedures were performed under tracheal intubation and intravenous anesthesia using the 3rd grade controlled radial expansion balloon with the gastroscope. Outcomes were recorded and predictors for outcomes were analyzed. Results: A total of 170 dilations were completed in 64 patients. The success rate was 96.9%. The rates of response, complication, and recurrence were 96.77%, 8.06%, and 3.33%, respectively. The number of dilatation sessions and complications were significant higher in patients with smaller diameter strictures (P = 0.013, 0.023), and in patients with multiple structures (P = 0.014, 0.004); more complication and recurrences were seen in patients with longer strictures (P = 0.001, 0.012). The longer the interval between surgery and first dilatation the more sessions and the poorer the response in the patients with anastomotic esophageal strictures (p = 0.017, 0.024). Conclusions: The diameter, length and number of stricture were the most important risk factors for poor outcomes of endoscopic balloon dilatation treatment of esophageal stricture.