球囊扩张治疗小儿先天性食道闭锁术后吻合口狭窄

目的评价食道球囊扩张治疗小儿食道先天性闭锁术后吻合口狭窄的安全性和有效性。方法20例先天性食道闭锁术后吻合口狭窄患儿，在X线透视下共行45次球囊扩张术。单个患儿扩张次数自1～5次不等。球囊直径范围为6～15mm。每次扩张前后行食道造影了解扩张效果。食道吻合口狭窄指数降至10％以下为扩张有效。球囊扩张术后随访3—6个月期间，患儿所进食物由流质向固体物质改变，呕吐症状改善，体重增加明显者为治疗有效。结果45次球囊扩张术有40次扩张成功。成功率为88．9％。无1例食道穿孔。3～6月随访16例患儿治疗有效。有效率达80％。结论球囊扩张治疗小儿先天性食道闭锁术后狭窄是有效且安全的治疗手段。

Balloon dilatation of children with anastomotic strictures following repair of esophageal atresia

Purpose To evaluate the efficiency and safety of balloon dilation treating anastomotic strictures secondary to repair of esophageal atresia in children. Methods Twenty cases had an anastomotic stricture following surgical repair of esophageal atresia.A total of 45 balloon dilatation sessions were performed under fluoroscopic guidance with a range of 1-5 procedures per patient.The diameter,of balloons were 6-15 mm.Each case had an oesophagraphy pre-dilatation to confirm the stricture,and a series of oesophagraphy post-dilatation to identify the effect of ballonn dilation.Dilatation was considered successful and effective when the final stricture index(SI) decreased to at least 10%,when swallowing problems were relieved up to 3 months after dilatation and when weight gain and growth were satisfactory. Results Totally 40 of 45(88.9%) balloon dilatation sessions were successful and there was no esophageal perforation.And 16 of 20(80%) patients were symptom free in the follow-up period varied from 3-6 months. Conclusions Balloon catheter dilation presented in the paper is a safe and efficient procedure to treat infants with anastomotic esophageal stricture secondary to repair of esophageal atresia.