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Autologous skin-grafting surgery to prevent esophageal stenosis after complete circular endoscopic submucosal tunnel dissection: a case-matched controlled study

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Abstract

Background

The incidence of postoperative stenosis after endoscopic resection of wholly circumferential superficial esophageal squamous cell neoplasms (SESCNs) is extremely high.

Methods

Between January 2011 and April 2019, 19 patients who underwent autologous skin-grafting surgery (ASGS) after complete circular endoscopic submucosal tunnel dissection (ccESTD) were enrolled to form the ASGS group. Cases in the ASGS group were individually matched at a 1:1 ratio to cases undergoing fully covered esophageal stent (FCES) placement alone (FCES group) based on pathological diagnosis, curative resection, longitudinal length of ulceration, lack of stent migration, time to stent removal, follow-up period and operators. Baseline characteristics and treatment outcomes were compared between the two groups.

Results

Baseline characteristics were comparable between the ASGS group and the FCES group. The incidence of patients with esophageal stenosis after removal of the stent in the ASGS group was significantly reduced compared that in the FCES group (36.8% vs 78.9%, p = 0.020). Comparison of preventive methods (ASGS vs FCES alone) between the stenosis group and nonstenosis group revealed that ASGS accounted for a higher proportion than FCES alone in the nonstenosis group (p = 0.020).

Conclusions

Compared with FCES placement alone, ASGS appeared to be more effective in preventing esophageal stenosis after ccESTD for SESCNs.

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Funding

There is no special financial support for the present study.

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Author notes

  1. Jiale Zou and Ningli Chai contributed equally to this work.

Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, The First Medical Center of PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China

    Jiale Zou, Ningli Chai, Enqiang Linghu, Huikai Li, Yongsheng Shi, Zantao Wang & Longsong Li

  2. Department of Plastic Surgery, The First Medical Center of PLA General Hospital, Beijing, 100853, China

    Mi Chai

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  1. Jiale Zou
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  2. Ningli Chai
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  3. Enqiang Linghu
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  6. Yongsheng Shi
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Contributions

Our research mainly designed by LE, CN and ZJ; ZJ followed up the patients, analyzed the data, and wrote the manuscript; LE and CN provided analytical oversight. ZJ and CN contributed equally to this work; LH, CM, SY, WZ and LL revised the manuscript for important intellectual content; all authors have read and approved the final version to be published.

Corresponding author

Correspondence to Enqiang Linghu.

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Disclosures

Drs. Jiale Zou, Ningli Chai, Enqiang Linghu, Huikai Li, Mi Chai, Yongsheng Shi, Zantao Wang and Longsong Li have no conflicts of interest or financial ties to disclose.

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Jiale Zou and Ningli Chai are co-first authors.

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Zou, J., Chai, N., Linghu, E. et al. Autologous skin-grafting surgery to prevent esophageal stenosis after complete circular endoscopic submucosal tunnel dissection: a case-matched controlled study. Surg Endosc 35, 5962–5970 (2021). https://doi.org/10.1007/s00464-020-08081-7

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  • DOI: https://doi.org/10.1007/s00464-020-08081-7

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