One of the most prevalent problems in esophageal atresia (EA) was anastomotic strictures after surgical correction. For a study, researchers sought to determine if esophageal stenting, combined with dilatation and other endoscopic treatments, could avert surgical stricture resection (SR). The secondary goals were to assess determinants of effective esophageal stenting and to assess stent-related adverse events. Investigators conducted a retrospective review of pediatric patients with EA complicated by esophageal strictures. The delta diameter (ΔD) was defined as the change in stricture diameter in millimeters from the time of stent removal to the time of subsequent endoscopy. The discriminating ability of ΔD was determined using a receiver operating characteristic (ROC) curve study. The Youden J index was used to determine the best threshold for predicting stent success. To assess success determinants, they used univariate and multivariate analyses. To treat esophageal strictures, 49 esophageal anastomoses were stented. In 41% of patients, stents avoided SR. The ideal cutoff point in differentiating stent success was established as ΔD of less than or equal to 4 mm (area under the curve=0.790; 95% CI: 0.655–0.924; P<0.001) by ROC curve analysis using the Youden J index. Erosion/ulcerations, granulation tissue growth, and vomiting/retching were the most common side effects. Stent therapy was beneficial in avoiding SR at the site of EA repair in 41% of the patients with good long-term follow-up. The change in luminal diameter (≤4 mm) at initial post-stent follow-up was the most important predictors of success in the study.

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

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