Esophageal stents in children: Bridge to surgical repair

Abstract

Management of complex esophageal problems in children is challenging. We report our experience with the use of esophageal stents in three children with esophageal strictures, leaks, or airway-esophageal fistulae refractory to conventional treatment. The stent played a key role in allowing extubation of a child with a large tracheo-esophageal-pleural fistula and in the resolution of pulmonary infection in a child with esophago-bronchial fistula, both followed by surgery. In the third child, with stricture, stents were complicated with migration, esophageal erosion, and esophago-bronchial fistula. In our experience, esophageal stents were useful mainly as a bridge to definitive surgical repair.

Keywords

Broncho-esophageal fistula - esophageal fistula - esophageal leak - esophageal stent - esophageal stricture - tracheo-esophageal fistula

Publication History

Article published online:
26 July 2021

• References

• 1 Wilson JL, Louie BE, Farivar AS, Vallières E, Aye RW. Fully Covered Self-Expanding Metal Stents Are Effective For Benign Esophagogastric Disruptions and Strictures. J Gastrointest Surg 2013; 17: 2045-50
• 2 van Halsema EE, van Hooft JE. Clinical outcomes of self-expandable stent placement for benign esophageal diseases: A pooled analysis of the literature. World J Gastrointest Endosc 2015; 7: 135-53
• 3 Zhang C, Yu JM, Fan GP, Shi CR, Yu SY, Wang HP. et al. The use of a retrievable self-expanding stent in treating childhood benign esophageal strictures. J Pediatr Surg 2005; 40: 501-4
• 4 Best C, Sudel B, Foker JE, Krosch TCK, Dietz C, Khan KM. Esophageal stenting in children: Indications, application, effectiveness, and complications. Gastrointest Endosc 2009; 70: 1248-53
• 5 Rollins MD, Barnhart DC. Treatment of persistent esophageal leaks in children with removable, covered stents. J Pediatr Surg 2012; 47: 1843-7
• 6 Broto J, Asensio M, Vernet JMG. Results of a New Technique in the Treatment of Severe Esopha. J Pediatr Gastroenterol Nutr 2003; 37: 203-6
• 7 Ahmad A, Wong LM, Song K, Absah I. Esophageal stent placement as a therapeutic option for iatrogenic esophageal perforation in children. Avicenna J Med 2016; 6: 51-3
• 8 Manfredi MA, Jennings RW, Anjum MW, Hamilton TE, Smithers CJ, Lightdale JR. Externally removable stents in the treatment of benign recalcitrant strictures and esophageal perforations in pediatric patients with esophageal atresia. Gastrointest Endosc 2014; 80: 246-52
• 9 Lange B, Kubiak R, Wessel LM, Kahler G. Use of fully covered self-expandable metal stents for benign esophageal disorders in children. J Laparoendosc Adv Surg Tech A 2015; 25: 335-41
• 10 Gebrail R. Successful use of esophageal stent placement to treat a postoperative esophageal stricture in a toddler. ACG Case Reports J 2014; 2: 61-3
• 11 Zhang J, Ren L, Huo J, Zhu Z, Liu D. The use of retrievable fully covered self-expanding metal stent in refractory postoperative restenosis of benign esophageal stricture in children. J Pediatr Surg 2013; 48: 2235-40
• 12 Kramer RE, Quiros JA. Esophageal stents for severe strictures in young children: Experience, benefits, and risk. Curr Gastroenterol Rep 2010; 12: 203-10
• 13 Hindy P, Hong J, Lam-Tsai Y, Gress F. A comprehensive review of esophageal stents. Clin Adv Hematol Oncol 2012; 10: 526-34
• 14 Katsanos K, Sabharwal T, Koletsis E, Fotiadis N, Roy-Choudhury S, Dougenis D. et al. Direct Erosion and Prolapse of Esophageal Stents into the Tracheobronchial Tree Leading to Life-threatening Airway Compromise. J Vasc Interv Radiol 2009; 20: 1491-5
• 15 Wang MQ, Sze DY, Wang ZP, Wang ZQ, Gao YA, Dake MD. Delayed complications after esophageal stent placement for treatment of malignant esophageal obstructions and esophagorespiratory fistulas. J Vasc Interv Radiol 2001; 12: 465-74
• 16 Khan S, George N, Tharian B. Extraluminal migration of an esophageal metal stent causing splenic injury. Endoscopy 2016; 48: E326