Comparative assesment of long-term outcomes of dilation in children with cicatricial esophageal strictures in chidren

Objective: to conduct a comparative analysis of long-term clinical outcomes and quality of life indicators in children with cicatricial esophageal strictures treated with different bougienage techniques.

Material and methods: a comparative cohort study was conducted on 83 children (1.5–14 years old) at the Department of Pediatric Surgery of the SEI ATSMU (Department of Thoracoabdominal Surgery of the National Center of Medicine “Shifobakhsh”, Republic of Tajikistan). The control group (n=34) underwent bougienage without visual control or “string- guided” bougienage; the study group (n=49) underwent dilation using a metal guidewire. Clinical outcomes, endoscopic and radiological data, and quality of life indicators (PedsQL™, adapted symptom scale) were evaluated. Statistical analysis was performed using χ², t-test, OR with 95% CI, and effect sizes (Cohen’s d). The significance level was set at p<0.05.

Results: the main group demonstrated significantly better quality of life indicators (p<0.001; d 1.01–1.70), as well as a lower frequency of unsatisfactory outcomes (4.2% vs. 16.7%). The severity of dysphagia and pain syndrome was statistically significantly lower in patients who underwent guidewire-assisted dilation.

Conclusion: guidewire-based dilation technology is associated with improved long-term clinical outcomes and quality of life in children with cicatricial esophageal stricture and may be considered the preferred treatment method.

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