Management and clinical outcomes of congenital esophageal st
Conservative treatment with esophageal balloon dilatations is an effective and reliable treatment for congenital esophageal stenosis (CES).

This study aimed to retrospectively investigate congenital esophageal stenosis (CES) cases managed at their institution using a non-aggressive strategy based on a step-up approach from esophageal balloon dilatations to surgery.

Patients’ charts with CES managed in a tertiary pediatric surgery department were retrospectively evaluated. Demographic characteristics, clinical features, pH-monitoring, imaging, and esophagoscopy results were recorded together with their treatments and outcomes. Nineteen patients, confirmed with radiologic and endoscopic investigations, were managed.

- Complete symptom resolution was achieved in 14 patients by a median of five recurrent esophageal balloon dilatations lasting for 7.5 months.

- Two more patients, after 7 and 15 dilatations, had mild dysphagia, not interfering with their daily living.

- One patient, in whom the initial dilatation attempt with 3 atm was unsuccessful, and two patients with persistent symptoms and growth retardation despite ongoing dilatation treatment, underwent surgery.

- After 48 months of follow-up, 17 patients were symptom-free.

Conservative treatment with esophageal balloon dilatations is an efficient and reliable modality that can be used as a first-line treatment in CES. Surgical treatment option should be used when dilatation attempt is unsuccessful, or symptoms and growth retardation persist despite dilatation treatment.

Journal of Pediatric Surgery