2019 Volume 55 Issue 2 Pages 242-247
Purpose: Congenital esophageal stenosis (CES) is rare, so a suitable treatment is controversial. We investigated the treatment strategy for CES.
Methods: The background characteristics, associated anomalies, onset time, time at diagnosis, stenotic site, esophagograms, type of disease, and treatment were examined retrospectively in 14 cases between 1992 and 2018.
Results: The associated anomalies were esophageal atresia in 3, congenital heart disease in 1, anorectal malformation in 1, and multiple small anomalies in 1. Ten patients showed esophageal obstruction, whose onset was after the introduction of solid foods in 8 and in the neonatal period in 2. The mean time from onset until diagnosis was 8.5 months. The levels of stenotic lesion were the upper esophagus in 1, the middle esophagus in 3, the lower esophagus in 8, and the middle and lower esophagus in 2. Esophagograms revealed abrupt narrowing in 9 and tapered narrowing in 4. Regarding the courses of treatment, 13 patients first underwent endoscopic dilatation (ED). The operative procedures were partial excision and end-to-end anastomosis in 2, circumcision in 1, half circumcision in 1, and myotomy followed by partial excision and end-to-end anastomosis in 1. The classifications of CES were fibromuscular thickening in 4, tracheobronchial remnant in 1, membranous web in 1, and unknown in 8.
Conclusions: As a first step, esophagography and endoscopic ultrasonography are recommended. We choose ED and carried it out with care to avoid causing esophageal perforation. Surgical operation should be restricted to cases intractable to ED. Consequently, considerable unnecessary operations for CES are avoidable.
