Esophageal stricture after endoscopic submucosal dissection treated successfully by temporary stent placement

Abstract

The growing use of endoscopic submucosal dissection (ESD) has enabled the highly curative treatment of early esophageal cancer. The circumferential extent of the tumor is reportedly related to the frequency of post-treatment stricture, with postoperative esophageal stricture reported to occur frequently when the post-resection mucosal defect exceeds 75 % of the esophageal luminal circumference. In some clinical cases, locally injected or orally administered steroids aimed at preventing post-treatment stricture fail to prevent re-stricture. Only two prior reports have investigated temporary stent placement for stricture after ESD for early esophageal cancer, and consensus is lacking on the appropriate duration and timing of stent placement. Here, we report our experience with a case of stricture after ESD for early esophageal cancer, in which temporary stent placement was effective for releasing the stricture for at least 6 months.

Effect of polyglycolic acid sheet plus esophageal stent placement in preventing esophageal stricture after endoscopic submucosal dissection in patients with early-stage esophageal cancer: A randomized, controlled trial

“…Among these, PGA sheet, a biodegradable suture material, could be used to prevent post-ESD esophageal stricture because of its advantages of reinforcing suture and minimal scar contracture, although the limitation of instability between the PGA sheet and wound surface after long-term pasting still exists[ 9 - 11 ]. Another popular method is stent placement, which is frequently used with covered self-expandable metal material, and has been verified to have curative effects on refractory stricture to some extent, although its complications, such as translocation and promotion of granulation tissue proliferation, still affect its clinical outcomes in EC patients[ 12 , 13 ].…”

Advances in the prevention and treatment of esophageal stricture after endoscopic submucosal dissection of early esophageal cancer

“…The patient had mild esophageal stricture, without dysphagia or other serious complications. Yamasaki et al [21] studied a patient with esophageal ulcers that were greater than half of the esophageal circumference after ESD. One month after the operation, the patient experienced dysphagia, which did not improve even after the patient received EBD four times.…”

“…Ezoe et al [15] Li et al [16] Yamasaki et al [21] The time required to relieve stricture is short Repeated in a short time, stricture is easy to replapse Perforation, hemorrhage may occur The high cost Esophageal stents…”

Circumferential esophageal carcinoma with a localized muscle layer defect that caused perforation during endoscopic submucosal dissection

“…d). However, because the patient developed a stenosis 3 weeks after ESD, a fully covered metal stent was inserted and removed after 3 weeks of indwelling. Two weeks later, the stenosis recurred.…”