This paper reviews the use of photodynamic therapy (PDT) in patients with Barrett's esophagus and esophageal carcinoma. We describe the history of PDT, mechanics, photosensitizers for PDT in patients with esophageal disease. Finally, we discuss its utility and limitations in this setting.
Aminolevulinic Acid ; Barrett Esophagus ; Dihematoporphyrin Ether ; Esophageal Diseases ; Esophageal Neoplasms ; Humans ; Mechanics ; Photochemotherapy ; Photosensitizing Agents ; Triazenes

BACKGROUND/AIMS: Stricture formation is a common complication after endoscopic mucosal resection. Predictors of stricture formation have not been well studied. METHODS: We conducted a retrospective, observational, descriptive study by using a prospective endoscopic mucosal resection database in a tertiary referral center. For each patient, we extracted the age, sex, lesion size, use of ablative therapy, and detection of esophageal strictures. The primary outcome was the presence of esophageal stricture at follow-up. Multivariate logistic regression was used to analyze the association between the primary outcome and predictors. RESULTS: Of 136 patients, 27% (n=37) had esophageal strictures. Thirty-two percent (n=44) needed endoscopic dilation to relieve dysphagia (median, 2; range, 1 to 8). Multivariate logistic regression analysis showed that the size of the lesion excised is associated with increased odds of having a stricture (odds ratio, 1.6; 95% confidence interval, 1.1 to 2.3; p=0.01), when controlling for age, sex, and ablative modalities. Similarly, the number of lesions removed in the index procedure was associated with increased odds of developing a stricture (odds ratio, 2.3; 95% confidence interval, 1.3 to 4.2; p=0.007). CONCLUSIONS: Stricture formation after esophageal endoscopic mucosal resection is common. Risk factors for stricture formation include large mucosal resections and the resection of multiple lesions on the initial procedure.
Barrett Esophagus ; Constriction, Pathologic ; Deglutition Disorders ; Endoscopy ; Esophageal Stenosis* ; Follow-Up Studies ; Humans ; Logistic Models ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Tertiary Care Centers