Stricture Occurring after Endoscopic Submucosal Dissection for Esophageal and Gastric Tumors.
- Author:
Gwang Ha KIM
1
;
Sam Ryong JEE
;
Jae Young JANG
;
Sung Kwan SHIN
;
Kee Don CHOI
;
Jun Haeng LEE
;
Sang Gyun KIM
;
Jae Kyu SUNG
;
Suck Chei CHOI
;
Seong Woo JEON
;
Byung Ik JANG
;
Kyu Chan HUH
;
Dong Kyung CHANG
;
Sung Ae JUNG
;
Bora KEUM
;
Jin Woong CHO
;
Il Ju CHOI
;
Hwoon Yong JUNG
Author Information
- Publication Type:Review
- Keywords: Stricture; Esophagus; Stomach; Endoscopic submucosal dissection
- MeSH: Congenital Abnormalities; Constriction, Pathologic*; Deglutition Disorders; Esophageal Neoplasms; Esophagus; Risk Factors; Steroids; Stomach; Ulcer
- From:Clinical Endoscopy 2014;47(6):516-522
- CountryRepublic of Korea
- Language:English
- Abstract: Endoscopic submucosal dissection (ESD) is a widely accepted treatment for early gastric and esophageal cancer. Compared to endoscopic mucosal resection, ESD has the advantage of enabling en bloc removal of tumors regardless of their size. However, ESD can result in a large artificial ulcer, which may lead to a considerable deformity. Circumferential mucosal defects of more than three-fourths the esophageal circumference, long longitudinal mucosal defects (>30 mm), and lesions in the upper esophagus are significant risk factors for the development of post-ESD strictures of the esophagus. In the stomach, a circumferential mucosal defects more than three-fourths in extent and longitudinal mucosal defects >5 cm are risk factors of post-ESD stricture. If scheduled early, regular endoscopic balloon dilation is effective in controlling and preventing post-ESD stricture. Moreover, intralesional steroid injections or oral steroids can achieve remission of dysphagia or reduce the need for repeated endoscopic balloon dilation. However, further study is needed to improve the prevention of stricture formation.
