Title :

An international survey on anastomotic stricture management after esophageal atresia repair: considerations and advisory statements

Author(s) :

Ten Kate, Chantal A. [Auteur]
Eramus MC-Sophia Children’s Hospital
Tambucci, Renato [Auteur]
Bambino Gesù Children’s Hospital [Rome, Italy]
Vlot, John [Auteur]
Eramus MC-Sophia Children’s Hospital
Spaander, Manon C. W. [Auteur]
Eramus MC-Sophia Children’s Hospital
gottrand, Fréderic [Auteur]
Institute for Translational Research in Inflammation - U 1286 [INFINITE (Ex-Liric)]
Wijnen, Rene M. H. [Auteur]
Eramus MC-Sophia Children’s Hospital
Dall'oglio, Luigi [Auteur]
Bambino Gesù Children’s Hospital [Rome, Italy]

Journal title :

Surgical endoscopy

Abbreviated title :

Surg Endosc

Volume number :

35

Pages :

3653–3661

Publisher :

Springer Link

Publication date :

2020-08-03

ISSN :

1432-2218

Keyword(s) :

Dilatation management
Esophageal atresia
Anastomotic strictures

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: Endoscopic dilatation is the first-line treatment of stricture formation after esophageal atresia (EA) repair. However, there is no consensus on how to perform these dilatation procedures which may lead to a ...
Show more >BACKGROUND: Endoscopic dilatation is the first-line treatment of stricture formation after esophageal atresia (EA) repair. However, there is no consensus on how to perform these dilatation procedures which may lead to a large variation between centers, countries and doctor's experience. This is the first cross-sectional study to provide an overview on differences in endoscopic dilatation treatment of pediatric anastomotic strictures worldwide. METHODS: An online questionnaire was sent to members of five pediatric medical networks, experienced in treating anastomotic strictures in children with EA. The main outcome was the difference in endoscopic dilatation procedures in various centers worldwide, including technical details, dilatation approach (routine or only in symptomatic patients), and adjuvant treatment options. Descriptive statistics were performed with SPSS. RESULTS: Responses from 115 centers from 32 countries worldwide were analyzed. The preferred approach was balloon dilatation (68%) with a guidewire (66%), performed by a pediatric gastroenterologist (n = 103) or pediatric surgeon (n = 48) in symptomatic patients (68%). In most centers, hydrostatic pressure was used for balloon dilatation. The insufflation duration was standardized in 59 centers with a median duration of 60 (range 5-300) seconds. The preferred first-line adjunctive treatments in case of recurrent strictures were intralesional steroids and topical mitomycin C, in respectively 47% and 31% of the centers. CONCLUSIONS: We found a large variation in stricture management in children with EA, which confirms the current lack of consensus. International networks for rare diseases are required for harmonizing and comparing the procedures, for which we give several suggestions.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Université de Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2021-07-06T12:47:44Z
2023-03-22T07:41:06Z