Efficacy and histopathological esophageal wall damage of biodegradable esophageal stents for treatment of severe refractory esophageal anastomotic stricture in a child with long gap esophageal atresia

被引：17

作者：

Okata Y. ^{[1
,3
]}

Hisamatsu C. ^{[1
]}

Bitoh Y. ^{[3
]}

Yokoi A. ^{[3
]}

Nishijima E. ^{[1
,3
]}

Maeda K. ^{[1
,3
]}

Yoshida M. ^{[4
]}

Ishida T. ^{[2
]}

Azuma T. ^{[2
]}

Kutsumi H. ^{[2
]}

机构：

[1] Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe

[2] Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe

[3] Department of Pediatric Surgery, Kobe Children’s Hospital, Kobe

[4] Department of Pathology, Kobe Children’s Hospital, Kobe

来源：

Clinical Journal of Gastroenterology | 2014年 / 7卷 / 6期

关键词：

Anastomotic stricture; Biodegradable; Esophageal atresia; Refractory; Stent;

D O I：

10.1007/s12328-014-0537-8

中图分类号：

学科分类号：

摘要：

A case in which a self-expandable biodegradable (BD) esophageal stent was used for a refractory esophageal anastomotic stricture (EAS) in a 5-year-old female is presented. The patient underwent closure of a tracheoesophageal fistula and gastrostomy in the neonatal period. Esophagoesophagostomy was performed at 18 months of age after a multistaged extrathoracic esophageal elongation procedure. The patient developed refractory EAS and required repeated esophageal balloon dilation. Four sessions of esophageal BD stenting were performed from the age of 5–8 years. Each BD stenting allowed her to eat chopped food, but the anastomotic stricture recurred 4–7 months after the procedure. No major complications were observed, though transient chest pain and dysphagia were observed after each stenting. Finally, at 8 years of age, EAS resection and esophagoesophageal anastomosis were performed. The resected specimens showed thickened scar formation at the EAS lesion, while the degree of esophageal wall damage, both at the proximal and distal ends of the stricture, was slight. To the best of our knowledge, this is the first case report of this kind of treatment and assessment of damage to the esophageal wall microscopically. The advantages and problems of the use of BD stents in children are discussed. © 2014, Springer Japan.

引用

页码：496 / 501

页数：5

共 15 条

[1]

Serhal L., Gottrand F., Sfeir R., Et al., Anastomotic stricture after surgical repair of esophageal atresia: frequency, risk factors, and efficacy of esophageal bougie dilatations, J Pediatr Surg, 45, pp. 1459-1462, (2010)

[2]

Repici A., Vleggaar F.P., Hassan C., Et al., Efficacy and safety of biodegradable stents for refractory benign esophageal strictures: the BEST (Biodegradable Esophageal Stent) study, Gastrointest Endosc, 72, pp. 927-934, (2010)

[3]

van Hooft J.E., van Berge Henegouwen M.I., Rauws E.A., Et al., Endoscopic treatment of benign anastomotic esophagogastric strictures with a biodegradable stent, Gastrointest Endosc, 73, pp. 1043-1047, (2011)

[4]

Kimura K., Nishijima E., Tsugawa C., Et al., Multistaged extrathoracic esophageal elongation procedure for long gap esophageal atresia: experience with 12 patients, J Pediatr Surg, 36, pp. 1725-1727, (2001)

[5]

Takamizawa S., Nishijima E., Tsugawa C., Et al., Multistaged esophageal elongation technique for long gap esophageal atresia: experience with 7 cases at a single institution, J Pediatr Surg, 40, pp. 781-784, (2005)

[6]

Takamizawa S., Yamanouchi E., Muraji T., Et al., MCRA of an anastomotic stenosis after esophagoesophagostomy for long gap esophageal atresia: a case report, J Pediatr Surg, 42, pp. 769-772, (2007)

[7]

Siersema P.D., Stenting for benign esophageal strictures, Endoscopy, 41, pp. 363-373, (2009)

[8]

Sharma P., Kozarek R., Role of esophageal stents in benign and malignant diseases, Am J Gastroenterol., 105, pp. 258-273, (2010)

[9]

Ham Y.H., Kim G.H., Plastic and biodegradable stents for complex and refractory benign esophageal strictures, Clin Endosc, 47, pp. 295-300, (2014)

[10]

Kramer R.E., Quiros J.A., Esophageal stents for severe strictures in young children: experience, benefits, and risk, Curr Gastroenterol Rep, 12, pp. 203-210, (2010)

← 1 2 →