• Che-Ming Chiang, Wen-Ming Hsu, Mei-Hwei Chang, Hong-Yuan Hsu, Yen-Hsuan Ni, Huey-Ling Chen, and Jia-Feng Wu.
• Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan; Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
• J Formos Med Assoc. 2021 Jan 1; 120 (1 Pt 2): 404-410.

Background/PurposeAnastomotic stricture (AS) is a major morbidity of patients with esophageal atresia (EA) after surgical reconstruction. Our study determined the risk factors of AS after EA reconstruction. The therapeutic efficacy and complications of esophageal dilatation for children with AS were also evaluated.MethodsForty children treated for EA between January 2008 and December 2018 were included in this retrospective analysis. Esophageal dilatation was performed when AS was diagnosed. The therapeutic effect of esophageal dilatation was determined based on nutritional status, as assessed by the weight-for-age z-score.ResultsSixteen EA patients developed AS. A gap >1.5 cm between the esophageal pouches (P = 0.02) in patients with EA and type A EA was a risk factor for developing AS. A mean of 7.7 sessions of esophageal dilatation were performed per patient, and no complications occurred. The nutritional status of EA children with AS after dilatation was not inferior to that of the children without AS at the 6-month follow-up.ConclusionA gap >1.5 cm between the esophageal pouches and type A EA are risk factors for AS after esophageal reconstruction. Esophageal dilatation is both safe and effective for managing strictures and improves nutritional status in EA children with AS.Copyright © 2020. Published by Elsevier B.V.

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