Risk factors of refractory esophageal stenosis after large-scale endoscopic submucosal dissection for patients with early esophageal cancer
10.3760/cma.j.issn.1007-5232.2017.06.002
- VernacularTitle:大范围早期食管癌内镜黏膜下剥离术后发生难治性狭窄的危险因素分析
- Author:
Jian TANG
;
Feng LIU
;
Jie CHEN
;
Xin'gang SHI
;
Zhaoshen LI
;
- Keywords:
Esophageal stenosis;
Early esophageal cancer;
Endoscopic submucosal dissection;
Risk factors
- From:
Chinese Journal of Digestive Endoscopy
2017;34(6):385-388
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors of refractory postoperative stenosis after large-scale endoscopic submucosal dissection (ESD) for patients with early esophageal cancer.Methods The data of 35 postoperative stenosis patients previously treated by ESD (dissection ≥3/4 circumferential) for early esophageal cancer from January 2011 to September 2016 in Digestive Endoscopy Center, Changhai Hospital were reviewed.According to the number of endoscopic dilation, 35 patients were divided into two groups: refractory stenosis (≥6 endoscopic dilations, n=21) and non-refractory stenosis (≤5 endoscopic dilations, n=14), comparison between the two groups was performed using t test or Fisher exact probability method.Results Muscle layer damage (P=0.018), longitudinal mucosal defect length (P=0.013), tumor infiltrating depth (P=0.031), and the number of hemostatic clips (P=0.031) were significantly different between the two groups.The history of chemotherapy and radiotherapy, the location of tumor, the macroscopic type, and the postoperative administration of oral prednisolone were not significant differences between the two groups (P>0.05).Conclusion Refractory esophageal stenosis commonly occurs in patients undergoing large-scale ESD with tumor depth >M2, muscle layer damage, longitudinal mucosal defect length ≥50 mm and the number of hemostatic clips ≥6.
