P1.053. Experience in Treating Children With Cicatricial Esophageal Stenosis of Various Etiologies Using Minimally Invasive Technologies

Abstract

Abstract Topic Benign Disease: Pediatric Esophageal Disorders Background Cicatricial stenosis is one of the most common esophageal pathologies in children. Many congenital and acquired conditions are known to cause deep damage to the esophageal wall, leading to cicatricial changes. The introduction of minimally invasive technologies allows for the preservation of organ function and a reduction in complications. Methods From 2020 to 2025, 120 patients with a cicatricial esophageal stenosis (or strictures) were treated in the thoracic surgery department. In most cases, cicatricial changes were a consequence of a chemical burn of the esophagus (32 patients), electrocautery burn due to swallowing flat lithium batteries (20 patients), due to reflux esophagitis (25 patients). Anastomotic stenosis after correction of esophageal atresia (30 patients) and congenital esophageal stenosis (13 patients) were also encountered. Cicatricial stenosis was divided according to anatomical and functional features: according to the length of cicatricial stenosis, short (up to 3 cm) were distinguished - 52.5% (63 patients), extended - 47.5% (57 patients). The presence of inflammatory changes in the esophageal mucosa played a significant role in the choice of treatment method. All patients were given a diagnostic algorithm that included X-ray contrast examination of the esophagus and stomach, endoscopic examination, and twenty-four-hour pH-metry. Results Children with cicatricial esophageal stenosis due to a chemical burn of the esophagus underwent direct esophageal bougienageusing a guide thread, followed by bougienage using an olive-shaped metal tip. Complications of this method included the development of reflux esophagitis (5 patients) and esophageal restenosis (3 patients) due to improper bougienage. Patients with electrocautery burns of the esophagus using a flat lithium battery, esophageal anastomosis stenosis after esophageal atresia correction, and congenital esophageal stenosis underwent courses of esophageal balloon dilation. Complications included deformation of the esophageal lumen and rupture of the esophageal mucosa. The most complex group of patients presented with stenosing reflux esophagitis and Barrett's esophagus. Conclusion The differentiated use of minimally invasive techniques (guideline bougienage, balloon dilation, photodynamic therapy) depending on the stricture characteristics and duration will enable the greatest effectiveness in the treatment of esophageal strictures. This research will expand the indications for the use of minimally invasive techniques in patients with esophageal stenosis.