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Dilations of anastomotic strictures over time after repair of esophageal atresia

Stenström, Pernilla LU ; Anderberg, Magnus LU ; Börjesson, Anna LU and Arnbjörnsson, Einar LU (2017) In Pediatric Surgery International 33(2). p.191-195
Abstract

Aim of the study: Anastomotic strictures commonly occur in patients undergoing surgery for esophageal atresia (EA). The primary aim of this study was to determine the age distribution of dilation procedures for anastomotic strictures over the patient’s childhood after reconstruction of EA. The secondary aim was to evaluate the effect of postoperative proton pump inhibitors (PPIs) on the frequency of dilations. Methods: This observational study was conducted at a single tertiary center of pediatric surgery. The times that dilations of strictures were performed were assessed during three study periods: 1983–1995, 2001–2009, and 2010–2014. PPIs were not used during the first period, and then, respectively, for 3 and 12 months... (More)

Aim of the study: Anastomotic strictures commonly occur in patients undergoing surgery for esophageal atresia (EA). The primary aim of this study was to determine the age distribution of dilation procedures for anastomotic strictures over the patient’s childhood after reconstruction of EA. The secondary aim was to evaluate the effect of postoperative proton pump inhibitors (PPIs) on the frequency of dilations. Methods: This observational study was conducted at a single tertiary center of pediatric surgery. The times that dilations of strictures were performed were assessed during three study periods: 1983–1995, 2001–2009, and 2010–2014. PPIs were not used during the first period, and then, respectively, for 3 and 12 months postoperatively. The indications for dilation were signs of obstruction and/or radiological signs of stricture. Primary results: A total of 131 children underwent esophageal reconstruction, and of those, 60 (46%) required at least 1 dilation procedure for strictures. There were no differences in the frequencies of dilation procedures between the three study periods (28/66, 18/32 and 14/33, respectively; P = 0.42). The overall median number of dilations per patient was 3 (range 1–21) with no differences between the study periods. The differences between ages at which the first dilation was performed during each study period were significant, as follows: 7, 2, and 8 months, respectively (P = 0.03). Fiftyone percent of all dilation procedures were performed during the first year of life, 16% during the second year, and 33% during years 2–15. Four children (2%) underwent >12 dilations. Conclusion: The first year of life was the time of greatest need for dilation of AS after reconstruction of EA; however, dilations were also performed several years later. PPIs did not affect the frequency of dilations during the first year of life.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anastomotic stricture (AS), Balloon dilation, proton pump inhibitors (PPIs), Esophageal atresia (EA)
in
Pediatric Surgery International
volume
33
issue
2
pages
5 pages
publisher
Springer
external identifiers
  • scopus:84995495722
  • wos:000393962600011
ISSN
0179-0358
DOI
10.1007/s00383-016-4013-z
language
English
LU publication?
yes
id
812bfbcd-a29e-4f14-a744-5216db5cf7d2
date added to LUP
2016-12-05 08:13:04
date last changed
2018-11-21 21:27:53
@article{812bfbcd-a29e-4f14-a744-5216db5cf7d2,
  abstract     = {<p>Aim of the study: Anastomotic strictures commonly occur in patients undergoing surgery for esophageal atresia (EA). The primary aim of this study was to determine the age distribution of dilation procedures for anastomotic strictures over the patient’s childhood after reconstruction of EA. The secondary aim was to evaluate the effect of postoperative proton pump inhibitors (PPIs) on the frequency of dilations. Methods: This observational study was conducted at a single tertiary center of pediatric surgery. The times that dilations of strictures were performed were assessed during three study periods: 1983–1995, 2001–2009, and 2010–2014. PPIs were not used during the first period, and then, respectively, for 3 and 12 months postoperatively. The indications for dilation were signs of obstruction and/or radiological signs of stricture. Primary results: A total of 131 children underwent esophageal reconstruction, and of those, 60 (46%) required at least 1 dilation procedure for strictures. There were no differences in the frequencies of dilation procedures between the three study periods (28/66, 18/32 and 14/33, respectively; P = 0.42). The overall median number of dilations per patient was 3 (range 1–21) with no differences between the study periods. The differences between ages at which the first dilation was performed during each study period were significant, as follows: 7, 2, and 8 months, respectively (P = 0.03). Fiftyone percent of all dilation procedures were performed during the first year of life, 16% during the second year, and 33% during years 2–15. Four children (2%) underwent &gt;12 dilations. Conclusion: The first year of life was the time of greatest need for dilation of AS after reconstruction of EA; however, dilations were also performed several years later. PPIs did not affect the frequency of dilations during the first year of life.</p>},
  author       = {Stenström, Pernilla and Anderberg, Magnus and Börjesson, Anna and Arnbjörnsson, Einar},
  issn         = {0179-0358},
  keyword      = {Anastomotic stricture (AS),Balloon dilation, proton pump inhibitors (PPIs),Esophageal atresia (EA)},
  language     = {eng},
  number       = {2},
  pages        = {191--195},
  publisher    = {Springer},
  series       = {Pediatric Surgery International},
  title        = {Dilations of anastomotic strictures over time after repair of esophageal atresia},
  url          = {http://dx.doi.org/10.1007/s00383-016-4013-z},
  volume       = {33},
  year         = {2017},
}