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Purpose <p>To evaluate early clinical outcomes and stricture formation in children with deep caustic esophageal burns managed using a standardized, injury-adapted protocol.</p> Methods <p>This prospective single-center study included children with endoscopically confirmed Zargar grade IIB–IIIA esophageal burns. All patients were managed according to a predefined protocol including early endoscopic assessment, temporary withdrawal and controlled reintroduction of oral feeding, systemic corticosteroid therapy, and avoidance of routine prophylactic dilation. The primary outcome was clinically significant esophageal stricture.</p> Results <p>A total of 31 patients were included. Clinically significant esophageal stricture developed in 3 patients (9.7%), which is markedly lower than the 40–70% rates reported for comparable deep injuries in previous studies. All strictures occurred within five weeks and were successfully treated with endoscopic dilation. No cases of esophageal perforation, emergency surgery, or mortality were observed.</p> Conclusion <p>Protocol-driven early management was associated with a low stricture rate and favorable short-term outcomes. These findings suggest that standardized early care and structured endoscopic surveillance may contribute to improved outcomes in children with deep caustic esophageal injury.</p>

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Low stricture rate with protocol-driven management of deep caustic esophageal burns in children: a prospective cohort study

  • 期刊论文

  • 发表日期：

    2026年5月24日

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  • Valentina V. Sarsenova,
  • Bauyrzhan N. Bissaliyev,
  • Assylbek B. Tussupkaliyev,
  • Zhenysbek T. Baubekov,
  • Sagidulla P. Dosmagambetov

摘要

Purpose

To evaluate early clinical outcomes and stricture formation in children with deep caustic esophageal burns managed using a standardized, injury-adapted protocol.

Methods

This prospective single-center study included children with endoscopically confirmed Zargar grade IIB–IIIA esophageal burns. All patients were managed according to a predefined protocol including early endoscopic assessment, temporary withdrawal and controlled reintroduction of oral feeding, systemic corticosteroid therapy, and avoidance of routine prophylactic dilation. The primary outcome was clinically significant esophageal stricture.

Results

A total of 31 patients were included. Clinically significant esophageal stricture developed in 3 patients (9.7%), which is markedly lower than the 40–70% rates reported for comparable deep injuries in previous studies. All strictures occurred within five weeks and were successfully treated with endoscopic dilation. No cases of esophageal perforation, emergency surgery, or mortality were observed.

Conclusion

Protocol-driven early management was associated with a low stricture rate and favorable short-term outcomes. These findings suggest that standardized early care and structured endoscopic surveillance may contribute to improved outcomes in children with deep caustic esophageal injury.