Refractory esophageal anastomotic stricture after esophageal atresia surgery improved with retrograde balloon dilatation through gastrostomy followed by laparoscopic fundoplication: a case report
Abstract Background An esophageal anastomotic stricture (EAS) after an esophageal atresia surgery occurs in approximately 4–60% of the cases, and its first-line therapy includes balloon dilatation. Oral balloon dilatation cannot be performed in some EAS cases; conversely, even if dilatation is possi...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-09-01
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| Series: | Surgical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40792-023-01754-0 |
| _version_ | 1827633360491511808 |
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| author | Yoichi Nakagawa Hiroo Uchida Akinari Hinoki Chiyoe Shirota Wataru Sumida Satoshi Makita Kazuki Yokota Hizuru Amano Akihiro Yasui Daiki Kato Yousuke Gohda Takuya Maeda |
| author_facet | Yoichi Nakagawa Hiroo Uchida Akinari Hinoki Chiyoe Shirota Wataru Sumida Satoshi Makita Kazuki Yokota Hizuru Amano Akihiro Yasui Daiki Kato Yousuke Gohda Takuya Maeda |
| author_sort | Yoichi Nakagawa |
| collection | DOAJ |
| description | Abstract Background An esophageal anastomotic stricture (EAS) after an esophageal atresia surgery occurs in approximately 4–60% of the cases, and its first-line therapy includes balloon dilatation. Oral balloon dilatation cannot be performed in some EAS cases; conversely, even if dilatation is possible, these strictures recur in some cases, necessitating a surgical procedure for repairing the stenosis. However, these procedures are invasive and have short- and long-term complications. If an EAS recurs repeatedly after multiple balloon dilations, gastroesophageal reflux disease (GERD) may be the underlying cause. A fundoplication procedure may be effective for treating a refractory EAS, as in the present case. Case presentation A neonatal patient with type D esophageal atresia underwent thoracoscopic esophago-esophageal anastomosis at the age of 1 day, and her postoperative course was uneventful. Thereafter, the patient underwent gastrostomy for poor oral intake at the age of 3 months. After gastrostomy, the patient presented with a complete obstructive EAS. Balloon dilatation via the oral route was attempted; however, a guidewire could not be inserted into the EAS site. Hence, retrograde balloon dilatation via gastrostomy was performed successfully. However, the EAS recurred easily thereafter, and laparoscopic anti-reflux surgery was performed to prevent GERD. The anti-reflux surgery cured the otherwise refractory EAS and prevented its recurrence. Conclusions Retrograde balloon dilatation is another treatment option for an EAS. When an EAS recurs soon after dilatation, the patient must be evaluated for GERD; if severe GERD is observed, an appropriate anti-reflux surgery is required before dilating the EAS. |
| first_indexed | 2024-03-09T14:58:28Z |
| format | Article |
| id | doaj.art-c7dadcdd04ce4dcaa92a7acfba1f2187 |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-03-09T14:58:28Z |
| publishDate | 2023-09-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-c7dadcdd04ce4dcaa92a7acfba1f21872023-11-26T14:03:40ZengSpringerOpenSurgical Case Reports2198-77932023-09-01911610.1186/s40792-023-01754-0Refractory esophageal anastomotic stricture after esophageal atresia surgery improved with retrograde balloon dilatation through gastrostomy followed by laparoscopic fundoplication: a case reportYoichi Nakagawa0Hiroo Uchida1Akinari Hinoki2Chiyoe Shirota3Wataru Sumida4Satoshi Makita5Kazuki Yokota6Hizuru Amano7Akihiro Yasui8Daiki Kato9Yousuke Gohda10Takuya Maeda11Department of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Rare/Intractable Cancer Analysis Research, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineDepartment of Pediatric Surgery, Nagoya University Graduate School of MedicineAbstract Background An esophageal anastomotic stricture (EAS) after an esophageal atresia surgery occurs in approximately 4–60% of the cases, and its first-line therapy includes balloon dilatation. Oral balloon dilatation cannot be performed in some EAS cases; conversely, even if dilatation is possible, these strictures recur in some cases, necessitating a surgical procedure for repairing the stenosis. However, these procedures are invasive and have short- and long-term complications. If an EAS recurs repeatedly after multiple balloon dilations, gastroesophageal reflux disease (GERD) may be the underlying cause. A fundoplication procedure may be effective for treating a refractory EAS, as in the present case. Case presentation A neonatal patient with type D esophageal atresia underwent thoracoscopic esophago-esophageal anastomosis at the age of 1 day, and her postoperative course was uneventful. Thereafter, the patient underwent gastrostomy for poor oral intake at the age of 3 months. After gastrostomy, the patient presented with a complete obstructive EAS. Balloon dilatation via the oral route was attempted; however, a guidewire could not be inserted into the EAS site. Hence, retrograde balloon dilatation via gastrostomy was performed successfully. However, the EAS recurred easily thereafter, and laparoscopic anti-reflux surgery was performed to prevent GERD. The anti-reflux surgery cured the otherwise refractory EAS and prevented its recurrence. Conclusions Retrograde balloon dilatation is another treatment option for an EAS. When an EAS recurs soon after dilatation, the patient must be evaluated for GERD; if severe GERD is observed, an appropriate anti-reflux surgery is required before dilating the EAS.https://doi.org/10.1186/s40792-023-01754-0Anastomotic strictureBalloon dilatationEsophageal atresia |
| spellingShingle | Yoichi Nakagawa Hiroo Uchida Akinari Hinoki Chiyoe Shirota Wataru Sumida Satoshi Makita Kazuki Yokota Hizuru Amano Akihiro Yasui Daiki Kato Yousuke Gohda Takuya Maeda Refractory esophageal anastomotic stricture after esophageal atresia surgery improved with retrograde balloon dilatation through gastrostomy followed by laparoscopic fundoplication: a case report Surgical Case Reports Anastomotic stricture Balloon dilatation Esophageal atresia |
| title | Refractory esophageal anastomotic stricture after esophageal atresia surgery improved with retrograde balloon dilatation through gastrostomy followed by laparoscopic fundoplication: a case report |
| title_full | Refractory esophageal anastomotic stricture after esophageal atresia surgery improved with retrograde balloon dilatation through gastrostomy followed by laparoscopic fundoplication: a case report |
| title_fullStr | Refractory esophageal anastomotic stricture after esophageal atresia surgery improved with retrograde balloon dilatation through gastrostomy followed by laparoscopic fundoplication: a case report |
| title_full_unstemmed | Refractory esophageal anastomotic stricture after esophageal atresia surgery improved with retrograde balloon dilatation through gastrostomy followed by laparoscopic fundoplication: a case report |
| title_short | Refractory esophageal anastomotic stricture after esophageal atresia surgery improved with retrograde balloon dilatation through gastrostomy followed by laparoscopic fundoplication: a case report |
| title_sort | refractory esophageal anastomotic stricture after esophageal atresia surgery improved with retrograde balloon dilatation through gastrostomy followed by laparoscopic fundoplication a case report |
| topic | Anastomotic stricture Balloon dilatation Esophageal atresia |
| url | https://doi.org/10.1186/s40792-023-01754-0 |
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