PMID- 30052567
OWN - NLM
STAT- MEDLINE
DCOM- 20191125
LR  - 20191210
IS  - 1536-4801 (Electronic)
IS  - 0277-2116 (Print)
IS  - 0277-2116 (Linking)
VI  - 67
IP  - 6
DP  - 2018 Dec
TI  - Approach and Safety of Esophageal Dilation for Treatment of Strictures in 
      Children With Epidermolysis Bullosa.
PG  - 701-705
LID - 10.1097/MPG.0000000000002106 [doi]
AB  - OBJECTIVE: The aim of the study is to analyze a large series of esophageal 
      balloon dilations in patients with epidermolysis bullosa (EB) to determine 
      procedural approach and frequency of post-endoscopic adverse events (AEs). 
      METHODS: Retrospective chart review for AE occurrence and clinical outcomes in 
      children and adolescents with EB, age 1 to 19, who underwent esophageal dilation 
      for esophageal stricture(s) from January 2003 to April 2016 at an academic, 
      tertiary care, free-standing children's hospital. The primary outcome measure was 
      occurrence of procedural AEs (defined as events occurring within 72 hours after 
      endoscopic dilation procedure). RESULTS: A total of 231 fluoroscopy-guided 
      esophageal balloon dilation procedures (209 anterograde, 20 retrograde, 2 both) 
      were performed in 24 patients. Strictures were more common in the proximal 
      portion of the esophagus with median stricture location 13 cm from the lips. From 
      2003 to 2012, 4.1% of dilations were retrograde. From 2013 to 2016, 20.2% of 
      dilations were retrograde. AEs attributable to dilation occurred after 10.0% of 
      procedures, and the most common AEs were vomiting, pain, and fever. No esophageal 
      perforations, serious bleeding events, or deaths occurred secondary to dilation. 
      The rate of post-dilation hospitalization was 6.9%. Dilation approach 
      (anterograde vs retrograde) did not impact the likelihood of AEs. CONCLUSIONS: 
      The characteristic esophageal lesion in EB is a single, proximal esophageal 
      stricture. EB patients can safely undergo repeat pneumatic esophageal balloon 
      dilations with minimal risk for severe complication. We observed a trend towards 
      increased use of retrograde esophageal dilation.
FAU - Anderson, Bradley T
AU  - Anderson BT
AD  - Department of Pediatrics.
FAU - Feinstein, James A
AU  - Feinstein JA
AD  - Department of Pediatrics.
AD  - Section of General Pediatrics.
FAU - Kramer, Robert E
AU  - Kramer RE
AD  - Department of Pediatrics.
AD  - Digestive Health Institute, Children's Hospital Colorado and the Section of 
      Pediatric Gastroenterology, Hepatology and Nutrition.
FAU - Narkewicz, Michael R
AU  - Narkewicz MR
AD  - Department of Pediatrics.
AD  - Digestive Health Institute, Children's Hospital Colorado and the Section of 
      Pediatric Gastroenterology, Hepatology and Nutrition.
FAU - Bruckner, Anna L
AU  - Bruckner AL
AD  - Department of Pediatrics.
AD  - Department of Dermatology, University of Colorado School of Medicine, Aurora, CO.
FAU - Brumbaugh, David E
AU  - Brumbaugh DE
AD  - Department of Pediatrics.
AD  - Digestive Health Institute, Children's Hospital Colorado and the Section of 
      Pediatric Gastroenterology, Hepatology and Nutrition.
LA  - eng
GR  - K23 HD091295/HD/NICHD NIH HHS/United States
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - J Pediatr Gastroenterol Nutr
JT  - Journal of pediatric gastroenterology and nutrition
JID - 8211545
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Dilatation/instrumentation/*methods
MH  - Epidermolysis Bullosa/*complications
MH  - Esophageal Stenosis/etiology/*surgery
MH  - Esophagoscopy/instrumentation/*methods
MH  - Esophagus/surgery
MH  - Female
MH  - Fluoroscopy/*methods
MH  - Humans
MH  - Infant
MH  - Male
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC6249086
MID - NIHMS981719
COIS- Conflicts of Interest: None declared.
EDAT- 2018/07/28 06:00
MHDA- 2019/11/26 06:00
PMCR- 2019/12/01
CRDT- 2018/07/28 06:00
PHST- 2018/07/28 06:00 [pubmed]
PHST- 2019/11/26 06:00 [medline]
PHST- 2018/07/28 06:00 [entrez]
PHST- 2019/12/01 00:00 [pmc-release]
AID - 10.1097/MPG.0000000000002106 [doi]
PST - ppublish
SO  - J Pediatr Gastroenterol Nutr. 2018 Dec;67(6):701-705. doi: 
      10.1097/MPG.0000000000002106.