Endoscopic‐guided platelet‐rich plasma for refractory oesophageal strictures in children: A single‐arm cohort study
Ileana González‐Natale, Daysmar Salazar, Maylin Davila, Yurihelis Saveri, María Eugenia Guerrero, Miguel Puga‐Tejada, Alberto BaptistaAbstract
Objectives
Oesophageal stenosis is a serious sequel of caustic ingestion, especially refractory caustic oesophageal strictures (COS) with a high risk of adverse events and variable response to treatments such as dilations, infiltration of substances and stent placement. Platelet‐rich plasma (PRP) has been used in various pathologies that require a process of repair and healing of tissues at the skin, mucosa and joints. We aimed to describe the experience managing refractory COS in children with endoscopic‐guided PRP intralesional administration, in terms of practicability of the procedure, efficacy and safety in the first prospective series in Venezuela.
Methods
Children with refractory COS, with a length of evolution between 7 months to 3 years, and previous treatment attempts (steroids, Mitomycin C or stent placement), underwent endoscopic‐guided PRP intralesional administration.
Results
Sixteen patients were included. After only one PRP administration session, 15/16 (93.8%) patients had improvement in dysphagia, in solid food tolerance and an increase in body weight. Only 4/16 ( p < 0.001) requested a second infiltration session. One patient was withdrawn from the follow‐up by the tutor. During the first 6‐month follow‐up, 15/15 patients, ( p < 0.001) presented without dysphagia. There was no adverse event related to the dilation or PRP administration.
Conclusions
The excellent response after endoscopic‐guided PRP intralesional administration represents an effective and safe alternative for refractory COS children.