ÖZET
Amaç:
Endoskopik balon dilatasyonu (EBD), özofagus atrezili hastalarda özofagus darlıklarının tedavisinde sıklıkla kullanılan bir yöntemdir. Bu makalenin amacı, özofagus atrezili hastalarda uygulanan EBD’deki 19 yıllık deneyimimizi aktarmaktır.
Gereç ve Yöntem:
2003-2022 yılları arasında özofagus darlığı gelişen ve EBD uygulanan 37 özofagus atrezili hasta çalışmaya dahil edildi. EBD seans sayısı, dilatasyonlar arasında geçen süre, dilate balonun boyutu, işlem sonrası komplikasyon gelişimi, ek cerrahi girişim ve takip süreleri değerlendirildi.
Bulgular:
Özofagus atrezisi olan hastalarda primer onarımdan ortalama 3,3 ay sonra, ortalama 0,72 ay (2 hafta-29 ay) aralıklarla EBD uygulandı. Altı hastada (%16,2) sadece bir kez EBD uygulandı ve bu hastalarda klinik semptom veya dilatasyon ihtiyacı görülmedi. Son iki dilatasyon işlemi arasında geçen süre 4,5 aydı (1-48). Yedi olguda (%8,8) dilatasyon işlemi sonrası özofagus perforasyonu görüldü ve konservatif olarak tedavi edildi. Hastaların 14’ünde dilatasyon ihtiyacının devam ettiği görüldü.
Sonuç:
EBD, özofagus atrezisi primer onarımı sonrası özofagus darlıkları için minimal invaziv ve güvenli bir yöntemdir. Anastomoz darlıklarında daha yüksek başarı oranı ile dilatasyonlar arası geçen süreyi uzatır. Optimal dilatasyon sayısı belirlenmeli ve öncelikle eşlik eden komorbiditeler tedavi edilmelidir.
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