Conservative treatment of corrosive esophageal strictures: a comparative study of endoscopic dilatations and esophageal stenting

From 1982 to 1990, 222 children (mean age 2.5 years, range 1–11 years) were admitted to Bambino Gesu' Children's Hospital for suspected caustic ingestion. In 126 cases (56.7%) esophageal injuries were evidenced on endoscopy, which was always performed within 24 h of the injestion. Eighteen children (8.1%) developed an esophageal stricture; 4 of these were treated surgically and the remaining 14 were included in two different protocols of conservative treatment: up to 1987, 7 patients (group 1) underwent periodic esophageal dilatations; from 1988 to 1990, 7 (group 2) were treated by esophageal stenting. In group 1, a mean of 25.1 ± 17.8 months and 19.3 ± 15.8 dilatations were necessary for the stenosis to heal completely. In group 2, disappearance of the stricture was achieved within 12.8 ± 9 months with a mean of 9.4 ± 11 dilatations. Esophageal stenting appeared to reduce by half both the duration of treatment and the number of dilatations required to obtain complete healing of corrosive stenoses. Moreover, the scars softened after stent placement, allowing safer dilatation of recurrent strictures.