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KMID : 1188320160100050757
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Gut and Liver
2016 Volume.10 No. 5 p.757 ~ p.763
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Antral or Pyloric Deformity Is a Risk Factor for the Development of Postendoscopic Submucosal Dissection Pyloric Strictures
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Hahn Kyu-Yeon
Park Jun-Chul
Lee Hyun-Jik
Park Chan-Hyuk
Chung Hyun-Soo
Shin Sung-Kwan
Lee Sang-Kil
Lee Yong-Chan
Sinn Dong-Hyun
Gwak Geum-Youn
Cho Hyun-Chin
Jung Sin-Ho
Paik Yong-Han
Choi Moon-Seok
Lee Joon-Hyeok
Koh Kwang-Cheol
Paik Seung-Woon
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Abstract
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Background/Aims:Surgeons must be aware of risk factors for strictures before performing endoscopic submucosal dissection (ESD), to enable early interventions to prevent severe strictures.
Methods:This study was a single-center retrospective study. We reviewed the clinical data of patients who has undergone gastric ESD from January 2007 to December 2012.
Results:Among the 3,819 patients who had undergone gastric ESD, 11 patients (7.2%) developed pyloric strictures and received successful endoscopic balloon dilation. Significant differences were noted between the patients without and with post-ESD strictures for pretreatment of antral or pyloric deformities (46.4% vs 81.8%), the proportion of extension to the lumen circumference (>3/4, 9.4% vs 54.5%), the longitudinal extent of mucosal defects (27.9±10.1 mm vs 51.5±10.8 mm), and post-ESD bleeding (2.9% vs 27.3%). Multivariate analysis revealed that pretreatment antral or pyloric deformities (odds ratio [OR], 30.53; 95% confidence interval [CI], 1.476 to 631.565; p=0.027), larger longitudinal extent of mucosal defects (OR, 1.20; 95% CI, 1.074 to 1.340; p=0.001), and circumferential extension of 3/4 (OR, 13.69; 95% CI, 1.583 to 118.387; p=0.017) were independent risk factors for post-ESD stricture.
Conclusions:Antral or pyloric deformities, sub-circumferential resection over more than 75% of the circumference and greater longitudinal extent of mucosal defects are independent risk factors for post-ESD stricture.
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KEYWORD
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Antral deformity, Pyloric deformity, Endoscopic submucosal dissection, Post-endoscopic submucosal dissection stricture
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