From 1975 through 1992, 932 patients with caustic esophageal burns wer
e admitted to the author's institution. Deep circumferential burns wer
e diagnosed esophagoscopically in 241 children within the first 48 hou
rs postburn. Initial treatment consisted of periodic anterograde and/o
r retrograde dilations of the injured and scarring esophagus (n = 172)
. In 1989, a long-term stenting technique was introduced, and a total
of 69 patients have been treated in this manner. The healing rates of
patients treated with traditional therapy were compared with those of
patients who had stenting, and a significant difference was noted (33%
v 68%; P < .01). Failure among the stented group was attributable to
poor patient compliance and to gastroesophageal reflux resulting from
shortening of the esophagus during scar formation. (C) 1996 by W.B. Sa
unders Company