One of the most prevalent problems in esophageal atresia is anastomotic strictures following surgical correction (EA). The role of esophageal stenting in the treatment of anastomotic esophageal strictures in children remained unknown. For a study, researchers sought to determine if esophageal stenting, in combination with dilatation and other endoscopic therapy, may avert surgical stricture resection (SR). Secondary goals were to assess determinants of effective esophageal stenting and to assess adverse events associated with stent insertion.

A review of pediatric patients with EA complicated by esophageal strictures were conducted. The delta diameter (D) was defined as the change in stricture diameter in millimeters from the time of stent removal to the time of the following endoscopy. To assess D’s discriminating abilities, a receiver operating characteristic (ROC) curve study was done. The Youden J index was used to determine the best cutoff point for predicting stent success. To analyze success determinants, a univariate and multivariate analysis was performed.

To treat esophageal strictures, 49 esophageal anastomoses were stented. Stents were shown to be effective in preventing SR in 41% of patients. Using the Youden J index, ROC curve analysis indicated that a D of 4 mm (area under the curve=0.790; 95% CI: 0.655–0.924; P<0.001) was the best cutoff point for discriminating stent success. The most prevalent adverse effects were erosions/ulcerations, the development of granulation tissue, and vomiting/retching. Stent treatment was efficacious in avoiding SR at the site of EA repair in 41% of the sample with satisfactory long-term follow-up.

Reference:journals.lww.com/jpgn/Abstract/2022/02000/Predictors_and_Outcomes_of_Fully_Covered_Stent.10.aspx