Risk factors for postoperative stricture after endoscopic submucosal dissection for superficial esophageal carcinoma

Shi, Qiang; Ju, Hui; Yao, Liang; Zhou, Ping‐Hong; Xu, Mei‐Dong; Chen, Tao; Zhou, Jiamin; Chen, Tianyin; Zhong, Yun‐Shi

doi:10.1055/s-0034-1365648

Cited by 119 publications

(101 citation statements)

References 11 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Post-ESD stricture is a major concern because it is associated with impaired quality of life. The possibility of stricture is known to be increased when the circumference of the lesion exceeds three-fourths of the total circumference of the esophagus [30,35-37]. In addition, longitudinal mucosal defects longer than 30 mm are a significant risk factor for the development of esophageal stricture [22].…”

Section: Discussionmentioning

confidence: 99%

Ten-year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center

Park

Kim

Gong

et al. 2016

Korean J Intern Med

View full text Add to dashboard Cite

Background/AimsEndoscopic submucosal dissection (ESD) of a superficial esophageal neoplasm (SEN) is a technically difficult procedure. We investigated the clinical outcomes of ESD to determine its feasibility and effectiveness for the treatment of SEN.MethodsPatients who underwent ESD for SEN between August 2005 and June 2014 were eligible for this study. The clinical features of patients and tumors, histopathologic characteristics, adverse events, results of endoscopic resection, and survival were investigated.ResultsESD was performed in 225 patients with 261 lesions, including 70 cases (26.8%) of dysplasias and 191 cases (73.2%) of squamous cell carcinomas. The median age was 65 years (range, 44 to 86), and the male to female ratio was 21.5:1. Median tumor size was 37 mm (range, 5 to 85) and median procedure time was 45 minutes (range, 9 to 160). En bloc resection was performed in 245 of 261 lesions (93.9%), with complete resection in 234 lesions (89.7%) and curative resection in 201 lesions (77.0%). Adverse events occurred in 33 cases (12.6%), including bleeding (1.5%), perforation (4.6%), and stricture (6.5%). During a median follow-up period of 35.0 months (interquartile range, 18 to 62), none of the patients showed local recurrence. The 5-year overall and disease-specific survival rates were 89.7% and 100%, respectively.ConclusionsESD is a feasible and effective procedure for the treatment of SEN based on our 10-year experience, which showed favorable outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Ten-year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center

Park

Kim

Gong

et al. 2016

Korean J Intern Med

View full text Add to dashboard Cite

show abstract

“…With the development of treatment modalities, ESD has been increasingly used for early superficial and submucosal esophageal tumors, with a reliable en bloc resection rate . However, ESD is challenging for esophageal lesions in large sizes with deep invasion due to a high risk of stricture, which affects the patient's daily life . Ono et al .…”

Section: Introductionmentioning

confidence: 99%

Intramuscular injection of mitomycin C combined with endoscopic dilation for benign esophageal strictures

Zhang

Wang

Liu

et al. 2015

J of Digest Diseases

View full text Add to dashboard Cite

show abstract

“…Development of strictures is a major postoperative adverse event of ESD, including sub-total to total circumferential resection, though the risk of developing strictures in the rectum is lower than for strictures with esophageal and gastric ESD [9,24,33]. In the case of stricture, EBD should help to resolve it, as was seen in the present case [9].…”

Section: Discussionmentioning

confidence: 52%

Electrolyte depletion syndrome (McKittrick–Wheelock syndrome) successfully treated by endoscopic submucosal dissection

Ohara

Toyonaga

Watanabe

et al. 2015

Clin J Gastroenterol

View full text Add to dashboard Cite

A 66-year-old woman presented to us with malaise, anorexia and rectal mucous discharge, and her laboratory data showed severe hyponatremia, hypokalemia, hypochloremia and renal failure. Computed tomography revealed massive occupation of the rectum by a large tumor. Colonoscopy revealed a mucus-rich villous tumor in the rectum. As there were no other factors that could cause an electrolyte disorder, she was diagnosed with McKittrick-Wheelock syndrome (MWS). The current standard treatment for MWS is partial surgical colectomy. However, surgeries are invasive and postoperative complications sometimes become an issue. After confirming no signs of submucosal invasion of the tumor by magnifying chromoendoscopic examination, endoscopic submucosal dissection (ESD) was indicated. The tumor was completely removed en bloc without adverse events. The histology showed a mucosal adenocarcinoma containing a villous component, 24.5 x 17.0 cm in size. This removal dramatically improved the patient's symptoms and the electrolyte abnormalities without medication. Although several sessions of endoscopic balloon dilation were required to treat postoperative stricture, she has been symptom-free and had no recurrence for 4 years after treatment. We experienced a case of MWS treated by ESD instead of surgery. ESD should be feasible and beneficial for the treatment of MWS.

show abstract

Risk factors for postoperative stricture after endoscopic submucosal dissection for superficial esophageal carcinoma

Abstract: Circumferential extension and histological depth were reliable risk factors for postoperative stricture.

Cited by 119 publications

References 11 publications

Ten-year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center

Ten-year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center

Intramuscular injection of mitomycin C combined with endoscopic dilation for benign esophageal strictures

Electrolyte depletion syndrome (McKittrick–Wheelock syndrome) successfully treated by endoscopic submucosal dissection

Contact Info

Product

Resources

About