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Future Directions for CES

  • Ashraf Ibrahim
  • Talal Al-Malki
Chapter

Abstract

The problems of esophageal motility disorder after successful repair of EA or in cases of isolated CES warrants further investigations. Endoscopic ultrasonography (EUS) is expected to play a wider diagnostic role for CES and its subtypes in the future. Large series of patients are required from multi centers to reach to a unified consensus for managing cases of CES. Emerging procedures like peroral endoscopic myotomy (POEM) and esophageal stenting are encouraging to be used in children and probably in infants. Specially designed esophageal stents for children are required to be available in the future. Novel fully covered (biodegradable) stents will be developed with optimal characteristics for refractory benign esophageal stricture (RBES) management. Stents will have a sufficiently high radial force and elasticity to reduce the risk of stent migration and tissue ingrowth, but also a low axial force, reducing severe adverse events and fistula formation. A combination of currently available modalities can be used together such as endoscopic electrocautery incisions and esophageal stenting. Prospective trials are required to demonstrate long-term efficacy and safety. Better quality stents and improvement in the techniques and protocols for stenting hold hopes for better results without complications.

Keywords

Congenital esophageal stenosis Esophageal atresia Endoscopic ultrasonography Peroral endoscopic myotomy Esophageal stents 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ashraf Ibrahim
    • 1
  • Talal Al-Malki
    • 2
  1. 1.Consultant Pediatric SurgeonArmed Forces Hospital, Southern Region, King Fahad Military HospitalKhamis MushaitSaudi Arabia
  2. 2.Senior Consultant Pediatric and Neonatal SurgeonAlhada Military Hospital, Vice President for D&Q, Taif UniversityTaifSaudi Arabia

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