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KMID : 1038120140470060516
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Clinical Endoscopy
2014 Volume.47 No. 6 p.516 ~ p.522
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Stricture Occurring after Endoscopic Submucosal Dissection for Esophageal and Gastric Tumors
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Kim Gwang-Ha
Jee Sam-Ryong
Jang Jae-Young
Shin Sung-Kwan
Choi Kee-Don
Lee Jun-Haeng
Kim Sang-Gyun
Sung Jae-Kyu
Choi Suck-Chei
Jeon Seong-Woo
Jang Byung-Ik
Huh Kyu-Chan
Chang Dong-Kyung
Jung Sung-Ae
Keum Bo-Ra
Cho Jin-Woong
Choi Il-Ju
Jung Hwoon-Yong
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Abstract
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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.
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KEYWORD
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Stricture, Esophagus, Stomach, Endoscopic submucosal dissection
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