Risk factors for cardiac and pyloric stenosis after endoscopic submucosal dissection, and efficacy of endoscopic balloon dilation treatment

Coda, Sergio; Oda, Ichiro; Gotoda, T.; Yokoi, Chizu; Kikuchi, Tsuyoshi; Ono, Hideki

doi:10.1055/s-0029-1214642

Cited by 100 publications

(116 citation statements)

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“…Procedure-related stricture was associated with an iatrogenic ulcer after the resection of large tumor near the pylorus. The reported risk factors for the stricture are circumferential extent of the mucosal defect of [ 3/4 or longitudinal extent of [5 cm [21][22][23]. In the present study, stricture occurred in 3.1 % of all lesions and 43.8 % of the lesions with the circumferential extent exceeded 3/4 of the total circumference of the pyloric ring.…”

Section: Discussionsupporting

confidence: 41%

Clinical outcomes of endoscopic resection for gastric neoplasms in the pylorus

et al. 2015

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Section: Discussionsupporting

confidence: 41%

Clinical outcomes of endoscopic resection for gastric neoplasms in the pylorus

et al. 2015

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“…Japanese experts recommend that surgeons perform ESD on gastric lesions fi rst, as they are technically easier to remove and exhibit a lower rate of complications compared to esophageal or colonic lesions [10,[12][13][14].…”

Section: Discussionmentioning

confidence: 99%

A Western single-center experience with endoscopic submucosal dissection for early gastrointestinal cancers

et al. 2010

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Patients and Methods PatientsTwenty-fi ve unselected consecutive patients (10 men and 15 women; mean age, 70 years; range, 47-88 years) with EGICs underwent ESD at our institution from April 2007 to September 2009. There were 3 esophageal, 7 gastric, 1 duodenal, and 14 colonic lesions (Table 1). The mean size of the lesions was 25 mm (range, 10-50 mm). Inclusion criteria followed those of Oyama [9] for lesions of the esophagus; the extended Gotoda criteria for the stomach [10]; and laterally spreading tumors (LSTs) greater than 20 mm in diameter [11] or Paris 0-II type lesions for the colon. Preoperative evaluationDiagnostic endoscopy included contrast chromoscopy with 0.2% indigo carmine dye or 2.5% Lugol solutions, or narrow band imaging (NBI) inspection, together with magnifying endoscopy (110 to 150×; Olympus GIFQ160Z or CFQ160Z; Olympus, Tokyo, Japan). Histological assessment confi rmed the lesions as low-grade or high-grade noninvasive neoplasia (LGNIN or HGNIN).All the patients were informed by oral and written explanation about the planned treatment. They were aware of the level of experience in ESD of the two operators (S.C. and P.T.). This study was conducted in accordance with the ethical principles of the Declaration of Helsinki and without any external fi nancial support. AbstractEndoscopic submucosal dissection (ESD) has gained worldwide acceptance as a treatment for early gastrointestinal cancers (EGICs). However, the management of these tumors in the Western world is still mainly surgical. Our aim was to evaluate the safety and feasibility of ESD at a European center. Based on the knowledge transferred by one of the most experienced Japanese institutions, we conducted a pilot study on 25 consecutive patients with EGICs located in the esophagus (n = 3), stomach (n = 7), duodenum (n = 1), and colon (n = 14) at our tertiary center over a 2-year-period. The main outcome measurements were complete (R0) resection, as well as en-bloc resection and the management of complications. The R0 and en-bloc resection rates were 100% and 84%, respectively. There were three cases of bleeding and fi ve cases of perforation. With a median follow up of 18 months, two recurrences were observed. We conclude that ESD for early esophageal and gastric cancers is feasible and effective, while colonic ESD requires more expertise.

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“…Other new treatments include biodegradable or metal stent insertion, topical application of mitomycin C or apposition of cell layers to prevent stricture formation (123)(124)(125)(126). Management of antral stenosis has been based on endoscopic balloon dilation, with a significant risk of perforation (127,128). Finally, mucosal incision and local triamcinolone injection has been assayed (129).…”

Section: Cicatricial Stenosismentioning

confidence: 99%