Preemptive dilatation gives good outcome to early esophageal stricture after circumferential endoscopic submucosal dissection. 2010

Vivien Wai-yin Wong, and Anthony Y Teoh, and Mitsuhiro Fujishiro, and Philip W Chiu, and Enders K W Ng
Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China. vivienwong@surgery.cuhk.edu.hk

Endoscopic submucosal dissection (ESD) is gaining popularity over endoscopic mucosal resection for treatment of superficial upper gastrointestinal cancers. It allows a more controlled en-bloc resection of intramucosal neoplasia allowing larger lesion in both stomach and esophagus to be resected. Lower local recurrence rate can be achieved. This is particularly important in the esophagus, as luminal stricture and deep fibrosis often hinder the possibility of repeat endoscopic resection of recurrences. The exact incidence of benign luminal strictures after the ESD of the esophagus lesion is unknown, but the risk is related to the circumferential extent of the lesion being resected, which is expected to develop in cases with post-ESD ulcer more than two-thirds of the circumference. We report 2 patients with early stenosis after circumferential ESD. We have also showed that scheduled early regular endoscopic balloon dilatation was effective in controlling and preventing post-ESD stricture. In conclusion, we suggest early follow-up esophagogastroduodenoscopy to be done for patients with circumferential ESD to determine the need of preemptive dilatation.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D004938 Esophageal Neoplasms Tumors or cancer of the ESOPHAGUS. Cancer of Esophagus,Esophageal Cancer,Cancer of the Esophagus,Esophagus Cancer,Esophagus Neoplasm,Neoplasms, Esophageal,Cancer, Esophageal,Cancer, Esophagus,Cancers, Esophageal,Cancers, Esophagus,Esophageal Cancers,Esophageal Neoplasm,Esophagus Cancers,Esophagus Neoplasms,Neoplasm, Esophageal,Neoplasm, Esophagus,Neoplasms, Esophagus
D004940 Esophageal Stenosis A stricture of the ESOPHAGUS. Most are acquired but can be congenital. Esophageal Stricture,Stenosis, Esophageal,Esophageal Stenoses,Stricture, Esophageal
D004945 Esophagoscopy Endoscopic examination, therapy or surgery of the esophagus. Esophagoscopic Surgical Procedures,Surgical Procedures, Esophagoscopic,Esophagoscopic Surgery,Surgery, Esophagoscopic,Esophagoscopic Surgeries,Esophagoscopic Surgical Procedure,Esophagoscopies,Procedure, Esophagoscopic Surgical,Procedures, Esophagoscopic Surgical,Surgeries, Esophagoscopic,Surgical Procedure, Esophagoscopic
D005753 Gastric Mucosa Lining of the STOMACH, consisting of an inner EPITHELIUM, a middle LAMINA PROPRIA, and an outer MUSCULARIS MUCOSAE. The surface cells produce MUCUS that protects the stomach from attack by digestive acid and enzymes. When the epithelium invaginates into the LAMINA PROPRIA at various region of the stomach (CARDIA; GASTRIC FUNDUS; and PYLORUS), different tubular gastric glands are formed. These glands consist of cells that secrete mucus, enzymes, HYDROCHLORIC ACID, or hormones. Cardiac Glands,Gastric Glands,Pyloric Glands,Cardiac Gland,Gastric Gland,Gastric Mucosas,Gland, Cardiac,Gland, Gastric,Gland, Pyloric,Glands, Cardiac,Glands, Gastric,Glands, Pyloric,Mucosa, Gastric,Mucosas, Gastric,Pyloric Gland
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor
D016145 Endoscopy, Digestive System Endoscopic examination, therapy or surgery of the digestive tract. Digestive System Endoscopic Surgical Procedures,Esophagogastroduodenoscopy,Surgical Procedures, Endoscopic, Digestive System,Digestive System Endoscopic Surgery,Endoscopic, Digestive System, Surgery,Endoscopic, Digestive System, Surgical Procedure,Procedure, Digestive System, Endoscopic, Surgical,Procedure, Endoscopic, Digestive System, Surgical,Procedures, Digestive System, Endoscopic, Surgical,Procedures, Endoscopic, Digestive System, Surgical,Surgery, Digestive System Endoscopic,Surgery, Endoscopic, Digestive System,Surgical Procedure, Endoscopic, Digestive System,Digestive System Endoscopies,Digestive System Endoscopy,Endoscopies, Digestive System,Esophagogastroduodenoscopies

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