Risk factors of refractory post-endoscopic submucosal dissection esophageal strictures

Robles, Enrique Pérez‐Cuadrado; Moreels, Tom G.; Piessevaux, Hubert; Yeung, Raymond W.; Aouattah, Tarik; Deprez, Pierre Henri

doi:10.17235/reed.2021.8061/2021

Cited by 4 publications

(3 citation statements)

References 35 publications

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“…A recent network meta-analysis supports the effectiveness of corticosteroids in patients with widespread esophageal ESD in the reduction of stricture rates and number of dilations needed [154]. Some retrospective studies compared oral steroids with injection treatment and found no significant difference [155,156]. However, since direct head-to-head comparisons between oral and locally injected corticosteroids are missing, no specific recommendation can be made on the optimal route and regimen.…”

Section: S)mentioning

confidence: 99%

“…There are no new reports on the management of these patients, except a recent retrospective study reporting on 83 patients who presented with post-ESD symptomatic esophageal strictures. Clinical success with dilation, plus triamcinolone injection in 50 % of the patients, was achieved in 84 % while refractory strictures were seen in 16 % [156]. Squamous cell carcinoma (SCC), upper esophageal location, recurrent strictures, and intraprocedural complications were statistically associated with refractory strictures.…”

Section: Esophageal Stricturesmentioning

confidence: 99%

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Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Libânio

Pimentel‐Nunes

Bastiaansen³

et al. 2023

Endoscopy

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ESGE suggests conventional endoscopic submucosal dissection (ESD; marking and mucosal incision followed by circumferential incision and stepwise submucosal dissection) for most esophageal and gastric lesions. ESGE suggests tunneling ESD for esophageal lesions involving more than two-thirds of the esophageal circumference. ESGE recommends the pocket-creation method for colorectal ESD, at least if traction devices are not used. The use of dedicated ESD knives with size adequate to the location/thickness of the gastrointestinal wall is recommended. It is suggested that isotonic saline or viscous solutions can be used for submucosal injection. ESGE recommends traction methods in esophageal and colorectal ESD and in selected gastric lesions. After gastric ESD, coagulation of visible vessels is recommended, and post-procedural high dose proton pump inhibitor (PPI) (or vonoprazan). ESGE recommends against routine closure of the ESD defect, except in duodenal ESD. ESGE recommends corticosteroids after resection of > 50 % of the esophageal circumference. The use of carbon dioxide when performing ESD is recommended. ESGE recommends against the performance of second-look endoscopy after ESD. ESGE recommends endoscopy/colonoscopy in the case of significant bleeding (hemodynamic instability, drop in hemoglobin > 2 g/dL, severe ongoing bleeding) to perform endoscopic hemostasis with thermal methods or clipping; hemostatic powders represent rescue therapies. ESGE recommends closure of immediate perforations with clips (through-the-scope or cap-mounted, depending on the size and shape of the perforation), as soon as possible but ideally after securing a good plane for further dissection.

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Section: S)mentioning

confidence: 99%

Section: Esophageal Stricturesmentioning

confidence: 99%

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Libânio

Pimentel‐Nunes

Bastiaansen³

et al. 2023

Endoscopy

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“…Esophageal stenosis is a common complication after endoscopic submucosal dissection (ESD) for early esophageal cancer 1 2 . Post-ESD esophageal stenosis is considered to be related to scar tissue proliferation and fibrosis during the healing process 3 .…”

Section: Figmentioning

confidence: 99%

Endoscopic esophageal cicatricotomy assisted by submucosal injection for the treatment of esophageal stenosis after endoscopic submucosal dissection

Ji,

Luo,

Wang

et al. 2023

Endoscopy

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Managing esophageal strictures following endoscopic resection of superficial neoplastic lesions

Delgado¹,

García²

2021

Rev Esp Enferm Dig

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Risk factors of refractory post-endoscopic submucosal dissection esophageal strictures

Cited by 4 publications

References 35 publications

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Endoscopic esophageal cicatricotomy assisted by submucosal injection for the treatment of esophageal stenosis after endoscopic submucosal dissection

Managing esophageal strictures following endoscopic resection of superficial neoplastic lesions

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