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Outcome of a novel self-control stricture-preventing water balloon for complete circular esophageal endoscopic submucosal dissection

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Abstract

Objectives

Post-ESD esophageal stricture especially after wholly circumferential ESD remains an unresolved issue without ideal strategies. Our initiative novel self-control stricture-preventing water balloon may be an alternative.

Methods

Patients with esophageal neoplastic lesions expected to result in a whole circular mucosa defect after esophageal ESD from February 2018 to August 2020 were included in the study. We used a novel self-control stricture-preventing water balloon combined with oral prednisolone as preventive strategy for the enrolled patients.

Results

Thirty-seven patients (9 females and 28 males, patients aged 52 to 82 years) finished the 12-week treatment including steroid treatment and balloon placement. The median size of longitudinal diameter was 7 cm (range from 4 to 14 cm). All the lesions achieved curative resection and the median procedure time was 110 min (range 50 to 180 min). Balloons were found migration in 4 patients. As a result, there were 3 patients (8.1%) experienced stricture. Generally, patients could tolerate to balloons, only with mild uncomfortableness, such as occasional sore throat, cough, and retrosternal pain. In addition, during the follow-up period, no significant adverse events associated to oral steroid administration were observed and no recurrence was found.

Conclusions

Our novel self-control stricture-preventing water balloon based on the oral steroid therapy is effective and safe. This strategy well prevents esophageal stricture after complete circumferential ESD.

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Acknowledgements

The study was supported by the Top-level Clinical Discipline Project of Shanghai Pudong (PWYgf2018-04).

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Author notes

  1. Jingjing Lian and Yuan Chu have contributed equally to this work.

Authors and Affiliations

  1. Endoscopy Center, Department of Gastroenterology, Shanghai East Hospital, School of Medicine, Tongji University, 150 Jimo Road, Shanghai, 200120, China

    Jingjing Lian, Yuan Chu, Tao Chen, Fang Li, Haibin Zhang & Meidong Xu

  2. Department of Gastroenterology and Hepatology, Jing’an District Central Hospital, Fudan University, Shanghai, China

    Aiping Xu

Authors
  1. Jingjing Lian
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  4. Fang Li
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  7. Meidong Xu
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Contributions

JL and YC contributed equally to this paper. JL designed the study and drafted the manuscript. YC enrolled patients and acquired the follow-up data. MX designed the balloon and performed the procedure. FL guided the patients and performed post-operative management. TC analyzed the data and reviewed the paper. AX and HZ acquired the clinical basic data.

Corresponding author

Correspondence to Meidong Xu.

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Disclosures

Drs Jingjing Lian, Yuan Chu, Tao Chen, Fang Li, Aiping Xu, Haibin Zhang, and Meidong Xu have no conflicts of interest or financial ties to disclose.

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Lian, J., Chu, Y., Chen, T. et al. Outcome of a novel self-control stricture-preventing water balloon for complete circular esophageal endoscopic submucosal dissection. Surg Endosc 37, 290–297 (2023). https://doi.org/10.1007/s00464-022-09456-8

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  • DOI: https://doi.org/10.1007/s00464-022-09456-8

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