Year 2021 / Volume 113 / Number 12
Original
Risk factors of refractory post-endoscopic submucosal dissection esophageal strictures

813-819

DOI: 10.17235/reed.2021.8061/2021

Enrique Pérez-Cuadrado Robles, Tom G. Moreels, Hubert Piessevaux, Ralph Yeung, Tarik Aouattah, Pierre H. Deprez,

Abstract
Introduction: our aim was to comparatively assess the treatment outcomes of endoscopic dilatation in Barrett’s neoplasia and squamous cell carcinoma (SCC) post-endoscopic submucosal dissection (ESD) strictures, and to determine the risk or factors associated to refractory strictures. Methods: an observational study. All consecutive patients presenting with a post-ESD stricture in 2007-2016 who underwent dilation therapy were included. Clinical, morphological, and technical features were assessed to determine the risk factors of refractory strictures. Results: of 414 consecutive patients treated by ESD, 83 (mean age: 65 ± 10 years, 76 % men) with 254 dilations (median: 3, range: 1-27) were considered. Barrett’s neoplasia and SCC were the indications in 58 (69.9 %) and in 25 (30.1 %) cases, respectively. Clinical success was achieved in 84.3 % with a median of 3 sessions (range: 1-22), with a higher rate in Barrett’s neoplasia (89.7 % vs. 72 %, p = 0.042). Circumferential resection in one single procedure (13.2 %) was associated with the need for a higher number of dilation sessions. By multivariate analysis, upper-esophageal location (OR: 11.479 [95 % CI: 2.058-64.043], p = 0.005), recurrent strictures (OR: 17.252 [95 % CI: 2.833-105.069], p = 0.002), and dilation-related complications (OR: 26.420 [95 % CI: 1.736-401.966], p = 0.018) were risk factors of refractory stenosis. Conclusion: patients presenting with SCC located in the upper superior esophagus, intra-procedural perforation, and recurrent strictures are at higher risk of developing refractory strictures.
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Pérez-Cuadrado Robles E, Moreels T, Piessevaux H, Yeung R, Aouattah T, Deprez P, et all. Risk factors of refractory post-endoscopic submucosal dissection esophageal strictures. 8061/2021


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Publication history

Received: 25/04/2021

Accepted: 09/09/2021

Online First: 14/09/2021

Published: 09/12/2021

Article revision time: 128 days

Article Online First time: 142 days

Article editing time: 228 days


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