Chapter 1 of 3 · Fundamentals
EA strictures
Introduction and Background on Esophageal Atresia Strictures
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
The standard treatment for esophageal atresia is surgery with an end to end anastomosis to restore continuity.
Stricture formation remains the most frequent post-operative complication in more than half of the cases of esophageal atresia.
The standard treatment for esophageal stricture is endoscopic dilatation either by bouginage or by balloon dilatation.
Worldwide, the balloon is most frequently used for esophageal stricture dilatation.
Intralesional steroid injections use triamcinolone (Kenalog) as the most common agent.
Steroids inhibit the formation of collagen, enhance its breakdown, and decrease fibrotic healing in esophageal strictures.
Each of the four quadrants of the esophageal stricture is injected with steroid in the STEPS-EA protocol.
110 children born with esophageal atresia are needed to prove the effectiveness of the steroid injection.
Study Group A will be injected with triamcinolone and then undergo balloon dilatation, while Study Group B will only undergo balloon dilatation.
A second esophagram will be performed to objectify the effectiveness of the intervention on the length and diameter of the stricture.
Physical length and weight will be measured at 4 time points throughout the 6 month study period to investigate possible systemic side effects of steroid injection.
A hair sample will be collected at the end of the follow-up period to measure cortisol levels to investigate possible systemic effects of intralesional steroid injection.