clinendoКлиническая эндоскопияFilin’s Clinical endoscopy2415-7813"Global Media technology" Ltd10.31146/2415-7813-endo-68-2-52-58clinendo-713Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL OBSERVATIONSЛечение стенозов пищевода при врожденном буллезном эпидермолизе у детей методом ретроградной баллонной дилатации: описание серии клинических случаевTreatment of Esophageal Stenosis in Children with Inherited Epidermolysis Bullosa by Retrograde Balloon Dilation: A Case SeriesТупыленкоА. В.TupylenkoA. V.tupylenkoav@mail.ruЛохматовМ. М.LokhmatovM. M.noemail@neicon.ruДьяконоваЕ. Ю.DyakonovaE. Yu.noemail@neicon.ruМурашкинН. Н.MurashkinN. N.noemail@neicon.ruОлдаковскийВ. И.OldakovskyV. I.noemail@neicon.ruКоролевГ. А.KorolevG. A.noemail@neicon.ruБудкинаТ. Н.BudkinaT. N.noemail@neicon.ruХватоваЕ. И.KhvatovaE. I.noemail@neicon.ruФедеральное государственное автономное учреждение «Национальный медицинский исследовательский центр здоровья детей» Министерства здравоохранения Российской ФедерацииNational Medical Research Center for Children’s Health2026230420266825258Copyright © Тупыленко А.В., Лохматов М.М., Дьяконова Е.Ю., Мурашкин Н.Н., Олдаковский В.И., Королев Г.А., Будкина Т.Н., Хватова Е.И., 20262026Тупыленко А.В., Лохматов М.М., Дьяконова Е.Ю., Мурашкин Н.Н., Олдаковский В.И., Королев Г.А., Будкина Т.Н., Хватова Е.И.Tupylenko A.V., Lokhmatov M.M., Dyakonova E.Y., Murashkin N.N., Oldakovsky V.I., Korolev G.A., Budkina T.N., Khvatova E.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://clinendo.elpub.ru/jour/article/view/713

Цель: оценить эффективность и безопасность ретроградной (через гастростому) баллонной дилатации (БД) пищеводных стриктур у детей с дистрофической формой врождённого буллёзного эпидермолиза (ДБЭ). Материалы и методы: выполнен ретроспективный анализ серии случаев (2016-2025): 8 детей с ДБЭ, дисфагией II-IV степени и установленной гастростомой. Выполняли ретроградную эндоскопически и рентгеноскопически ассистированную БД; в плане предоперационной подготовки выполнялась эзофагограмма с водорастворимым контрастом. Использовались баллоны диаметром от 10 до 15 мм (длина 55 мм); анестезия - ингаляционная масочная на самостоятельном дыхании. Оценивали локализацию/протяжённость стриктур, диаметр просвета, динамику дисагии по шкале Bown, частоту осложнений, рецидивы и длительность ремиссии. Результаты: стриктуры преимущественно располагались в верхней трети пищевода (6/8); у двух пациентов выявлено по две стриктуры (верхняя/средняя треть). Средний диаметр просвета при дилатации составил 4 ± 1,6 мм; клинический успех достигнут у 100% детей. Тяжесть дисфагии снизилась с 2,7 ± 0,7 до 0,4 ± 0,5 балла по Bown; серьёзных осложнений не зафиксировано (у двух пациентов отмечались умеренные боли при глотании в течение 3-5 суток). В течение двух лет у всех наблюдались рецидивы, требовавшие повторных ретроградных дилатаций; длительность ремиссии составляла 6-18 месяцев. Заключение: ретроградная БД у детей с ДБЭ демонстрирует высокую эффективность и благоприятный профиль безопасности, позволяя избежать травмы ротоглотки. Метод целесообразен при наличии гастростомы; для прямого сравнения с антеградной БД необходимы более крупные проспективные исследования.

Objective. To evaluate the efficacy and safety of retrograde (gastrostomy-assisted) balloon dilation (BD) for esophageal strictures in children with dystrophic epidermolysis bullosa (DEB). Materials and Methods. Single-center retrospective case series (2016-2025): eight children with DEB and grade II-IV dysphagia underwent retrograde BD via a mature gastrostomy under combined endoscopic and fluoroscopic guidance; preoperative work-up included a water-soluble contrast esophagogram. Balloons 10-15 mm in diameter (length 55 mm) were used; anesthesia was inhalational mask anesthesia with spontaneous ventilation. Outcomes included stricture location/length, luminal diameter, change in Bown dysphagia score, adverse events, recurrences, and remission duration. Results. Strictures were predominantly located in the upper third of the esophagus (6/8); two patients had two strictures (upper/mid-third). Mean luminal diameter at dilatation was 4 ± 1.6 mm; clinical success was achieved in 100% of patients. The Bown score improved from 2.7 ± 0.7 to 0.4 ± 0.5. No major complications occurred (only moderate odynophagia for 3-5 days). Over two years of follow-up, all patients experienced recurrences requiring repeat retrograde dilations; remission duration was 6-18 months. Conclusion. Retrograde BD in children with DEB demonstrates high efficacy and a favorable safety profile while avoiding oropharyngeal trauma. The technique is appropriate in the presence of a gastrostomy; larger prospective studies are needed for head-to-head comparison with antegrade BD.

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The authors declare that there are no conflicts of interest present.