Safety and Efficacy of steroid injection with endoscopic dilatation in pediatric refractory benign esophageal stricture: a Clinical trials

Background and Study Aim : While dilation therapy is the primary treatment for benign esophageal strictures, the recurrence or lack of responsiveness of strictures to this treatment can necessitate additional or repeated treatment. The objective of this study was to investigate the efficacy and safety of intralesional steroid injections (ISIs) in addition to dilation in patients with refractory benign esophageal strictures. Methods : The clinical trial included 21 pediatric patients with refractory benign esophageal strictures. An upper gastrointestinal endoscopy was conducted to the level of the stricture, after which esophageal dilation was performed. Subsequently, endoscopy was repeated, and a steroid was injected intralesionally under direct endoscopic vision. The procedure's efficacy was evaluated over 12 months by assessing several parameters, including the number of dilatations, maximum dilator size, periodic dilatation index (PDI), and dysphagia score. Results : The response to steroids was successful in 17 patients (81%) and unsuccessful in 4 patients (19%). The number of dilatations, PDI, and dysphagia score were significantly reduced following ISIs in comparison to pre-injection. Conversely, the maximum dilator size demonstrated a significant increase following ISIs compared to the pre-injection period. No side effects following steroid injections in children with esophageal strictures were reported in this study. Conclusion : Endoscopic dilatation followed by steroid injection is a useful strategy for the treatment of refractory benign esophageal strictures.