Analysis of clinical efficacy of surgical progressive treatment for corrosive esophageal stricture in children

OBJECTIVE: To explore the clinical efficacy of surgical progressive individualized treatment for corrosive esophageal stricture in children. METHODS: A retrospective analysis was conducted on the medical records of 52 children with corrosive esophageal stricture who were treated and followed up regularly in the Department of Cardiothoracic Surgery, Children's Hospital Affiliated to Nanjing Medical University from January 2017 to December 2024, including 30 males and 22 females, with an age of (4.20 ± 0.81) years and a weight of (12.20 ± 1.35) kg. There were 18 cases of acid substance ingestion, 31 cases of alkaline substance ingestion, and 3 cases of button battery ingestion. Sequential treatment methods including gastroscopic balloon dilation under direct vision, balloon dilation combined with submucosal injection of Mitomycin C into the esophagus, esophageal stent placement, and esophageal reconstruction were applied for the treatment of corrosive esophageal stricture in children. Postoperatively, the degree of esophageal stricture was observed via esophagography and gastroscopy, and the clinical efficacy of the surgical progressive treatment was evaluated in combination with the children's dysphagia grade. The t-test or chi-square test was used for difference comparison. RESULTS: All 52 children were discharged successfully. All children underwent balloon dilation treatment, among which 22 cases treated with simple gastroscopic balloon dilation under direct vision achieved good results; 30 cases received balloon dilation combined with submucosal injection of Mitomycin C into the esophagus, of which 16 cases achieved good results and 14 cases underwent esophageal stent placement; 14 cases underwent esophageal stent placement, of which 9 cases achieved good results and 5 cases underwent surgical treatment with good results. CONCLUSION: The progressive individualized methods of gastroscopic balloon dilation under direct vision, balloon dilation combined with submucosal injection of Mitomycin C into the esophagus, esophageal stent placement, and esophageal reconstruction have definite clinical effects in the treatment of corrosive esophageal stricture in children, with simple methods that are easy to operate and promote.