Behandling av øsofagusstriktur hos barn

Abstract

Abstract Aim of the thesis: To describe etiologies and management of esophageal strictures in children in general, and evaluate the treatment and results for this condition at Oslo University Hospital Rikshospitalet (OUS-R). Patients and methods: Unsystematic searches in PubMed with the words esophageal stricture , children , mitomycin c , stent , steroid and endoscopic dilation in different combinations were made to find relevant literature. A retrospective study on patients treated for esophageal stricture at OUS-R in the period January 2007 until September 2012. Results: Management of esophageal stricture in children consist of endoscopic balloon dilations (EBD), the medical adjuvants triamcinolone and mitomycin c, stents and surgery. A total of 373 endoscopic balloon dilations (EBD) were performed on 35 patients (20 male, 15 female). The etiologies were esophageal atresia (EA) (n=33) and corrosive injury (n=2). Time of follow up ranged from 5 to 66 months after the first treatment. Age at diagnosis was 0-64 months. Patients with EA type C (n=28) had mean 6.5 (1-39) EBD. Long gap EA patients (n=5) underwent mean 17.8 (9-28) EBD. Patients with corrosive injuries had 28 and 74 EBD. No perforations occurred. In total, seven patients had Mitomycin C treatments, 9 patients had steroid injections and 6 patients were treated with retrievable stents. Conclusions A low complication rate implicates EBD as a safe treatment for esophageal strictures in children. OUS-R seems to have more EBD in EA patients compared to several other studies. OUS-R does not follow an algoritm for treatment of esophageal strictures.

Abstract Aim of the thesis: To describe etiologies and management of esophageal strictures in children in general, and evaluate the treatment and results for this condition at Oslo University Hospital Rikshospitalet (OUS-R). Patients and methods: Unsystematic searches in PubMed with the words esophageal stricture , children , mitomycin c , stent , steroid and endoscopic dilation in different combinations were made to find relevant literature. A retrospective study on patients treated for esophageal stricture at OUS-R in the period January 2007 until September 2012. Results: Management of esophageal stricture in children consist of endoscopic balloon dilations (EBD), the medical adjuvants triamcinolone and mitomycin c, stents and surgery. A total of 373 endoscopic balloon dilations (EBD) were performed on 35 patients (20 male, 15 female). The etiologies were esophageal atresia (EA) (n=33) and corrosive injury (n=2). Time of follow up ranged from 5 to 66 months after the first treatment. Age at diagnosis was 0-64 months. Patients with EA type C (n=28) had mean 6.5 (1-39) EBD. Long gap EA patients (n=5) underwent mean 17.8 (9-28) EBD. Patients with corrosive injuries had 28 and 74 EBD. No perforations occurred. In total, seven patients had Mitomycin C treatments, 9 patients had steroid injections and 6 patients were treated with retrievable stents. Conclusions A low complication rate implicates EBD as a safe treatment for esophageal strictures in children. OUS-R seems to have more EBD in EA patients compared to several other studies. OUS-R does not follow an algoritm for treatment of esophageal strictures.