Endoscopic‐guided platelet‐rich plasma for refractory oesophageal strictures in children: A single‐arm cohort study

Abstract

OBJECTIVES: Oesophageal stenosis is a serious sequel of caustic ingestion, especially refractory caustic oesophageal strictures (COS) with a high risk of adverse events and variable response to treatments such as dilations, infiltration of substances and stent placement. Platelet-rich plasma (PRP) has been used in various pathologies that require a process of repair and healing of tissues at the skin, mucosa and joints. We aimed to describe the experience managing refractory COS in children with endoscopic-guided PRP intralesional administration, in terms of practicability of the procedure, efficacy and safety in the first prospective series in Venezuela. METHODS: Children with refractory COS, with a length of evolution between 7 months to 3 years, and previous treatment attempts (steroids, Mitomycin C or stent placement), underwent endoscopic-guided PRP intralesional administration. RESULTS: Sixteen patients were included. After only one PRP administration session, 15/16 (93.8%) patients had improvement in dysphagia, in solid food tolerance and an increase in body weight. Only 4/16 (p < 0.001) requested a second infiltration session. One patient was withdrawn from the follow-up by the tutor. During the first 6-month follow-up, 15/15 patients, (p < 0.001) presented without dysphagia. There was no adverse event related to the dilation or PRP administration. CONCLUSIONS: The excellent response after endoscopic-guided PRP intralesional administration represents an effective and safe alternative for refractory COS children.