Abstract
Purpose: The treatment of congenital esophageal stenosis (CES) requires careful management. We report the results of a follow-up study of CES.
Methods: Fifteen CES cases were collected prospectively from 1977 to 2015.
Results: Coexisting anomalies were type-C esophageal atresia in 4 patients, congenital heart disease in 4, and duodenal atresia in 2. Onset ages were mostly after the introduction of solid foods in 11 patients. Three patients revealed early onsets. The mean time from onset until diagnosis was 9.3 months. The levels of stenosis were the upper esophagus in 1 patient, the middle in 2 patients, and the lower in 12 patients. Esophagograms revealed tapered narrowing in 11 patients and abrupt narrowing in 4 patients. Regarding the courses of treatment, 2 patients only underwent surgical operation, after which their symptoms improved. The other 13 patients underwent endoscopic dilatation (ED), among which 4 improved and 9 did not. These 9 patients underwent surgical operation, followed by ED, which resulted in the improvement of symptoms in 8 patients but not in 1 patient who revealed two stenotic sites and required reoperation. The surgical approaches were thoracic in 4, abdominal in 6, and thoraco-abdominal in 1 patient (with two stenotic sites) according to stenotic levels. Recently, endoscopic surgeries have been performed in 4 patients. The operative procedures were myotomy in 4, partial excision in 6, and segmental resection, end-to-end anastomosis and myotomy in 1 patient with two stenotic sites. The surgical operation with the abdominal approach was accompanied by fundoplication in 7 patients. The classifications were tracheobronchial remnant in 4, fibromuscular thickening in 10, and membranous web in 1 patient.
Conclusions: The diagnosis of CES is difficult, and each patient requires careful management. Partial resection and transverse anastomosis are considered effective in the surgical management of CES.
