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Surgical Endoscopy

, Volume 30, Issue 9, pp 4049–4056 | Cite as

Risk factors for esophageal stenosis after entire circumferential endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma

  • Tomohiro Miwata
  • Shiro OkaEmail author
  • Shinji Tanaka
  • Kenichi Kagemoto
  • Yoji Sanomura
  • Yuji Urabe
  • Toru Hiyama
  • Kazuaki Chayama
Article

Abstract

Background

Endoscopic submucosal dissection (ESD) is used to perform en block resection for esophageal squamous cell carcinoma, but it is strongly associated with postoperative stenosis, especially during entire circumferential resection. This study aimed to clarify the risk factors for refractory postoperative stenosis after entire circumferential esophageal ESD.

Methods

Nineteen patients who underwent entire circumferential esophageal ESD from February 2006 to December 2013 at Hiroshima University Hospital were divided into two groups: refractory postoperative stenosis [≥6 endoscopic balloon dilation (EBD) procedures, 12 lesions in 12 patients] and non-refractory postoperative stenosis (≤5 EBD procedures, 7 lesions in 7 patients). We retrospectively examined the patient factors (age, sex, alcohol consumption, smoking index, and chemoradiation therapy history), tumor factors (location, macroscopic type, fibrosis, and depth), and treatment factors (mean procedure time, entire circumferential resection diameter, muscle layer damage, and steroid administration method) between the two groups.

Results

Muscle layer damage (p = 0.019) and ≥5 cm of longitudinal mucosal defect length after entire circumferential esophageal ESD (p = 0.010) were significant factors associated with the refractory group. Regarding the patient and tumor factors, there were no significant differences between the two groups.

Conclusion

Our data suggest that refractory post-ESD stenosis occurs after entire circumferential esophageal ESD with muscle layer damage and ≥5 cm of longitudinal mucosal defect length.

Keywords

Esophageal squamous cell carcinoma Surgical procedure Endoscopic Stenosis Steroids Risk factors 

Notes

Compliance with ethical standards

Disclosures

Tomohiro Miwata, Shiro Oka, Shinji Tanaka, Kenichi Kagemoto, Yoji Sanomura, Yuji Urabe, Toru Hiyama, and Kazuaki Cyayama have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Tomohiro Miwata
    • 1
  • Shiro Oka
    • 2
    • 4
    Email author
  • Shinji Tanaka
    • 2
  • Kenichi Kagemoto
    • 1
  • Yoji Sanomura
    • 2
  • Yuji Urabe
    • 1
  • Toru Hiyama
    • 3
  • Kazuaki Chayama
    • 1
  1. 1.Department of Gastroenterology and Metabolism, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
  2. 2.Department of EndoscopyHiroshima University HospitalHiroshimaJapan
  3. 3.Health Service CenterHiroshima UniversityHigashihiroshimaJapan
  4. 4.Department of Gastroenterology and Metabolism, Graduate Departments of EndoscopyHiroshima University HospitalHiroshimaJapan

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