Comparison between bougie and balloon dilation of benign esophageal strictures in infants and children

Objectives

The clinical outcomes regarding esophageal dilation are mainly composed of data collected from adults, who are likely to differ from children. The safety and efficacy of the bougie and balloon dilation were compared in two groups with benign esophageal strictures (BES) in infants and children.

Methods

The medical records of the BES patients, who received esophageal dilation between 2013 and 2024, were reviewed retrospectively. Bougie dilators were used in 19 patients (Group A) and balloon dilators in 18 patients (Group B). The etiology of strictures, degree and location of strictures, dilation methods, complications and dilation outcomes of bougie and balloon dilations were evaluated and compared.

Results

Thirty-seven patients [21 males and 16 females with a mean age of 6.2 years (range, 0.1–17)] underwent 124 esophageal dilations. The stricture etiologies included corrosive strictures (40.5 %), anastomotic strictures (40.5 %), and others in 18.9 %. Dysphagia relief was observed in all patients after the dilation, except for one session of dilation in each of the two groups. The technical success rate was 99.2 % in group A and 98.9 % in group B, respectively. The mean diameter of strictures increased significantly after dilation (P < 0.0001). Thirty patients (81.1 %) had clinical symptoms regress after repeated dilations, and dysphagia was relieved in the remaining 6 patients during the follow-up period. There was no procedure-related mortality or major complications, including esophageal ruptures or massive bleeding. Mild bleeding was the most common complication.

Conclusion

Bougies and balloon catheters are safe, effective and well tolerated in both groups with BES in infants and children. More future randomized prospective studies will be needed to validate the results.