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Digestive Diseases and Sciences

, Volume 59, Issue 3, pp 658–663 | Cite as

Preventing Stricture Formation by Covered Esophageal Stent Placement After Endoscopic Submucosal Dissection for Early Esophageal Cancer

  • Jing Wen
  • Yunsheng Yang
  • Qingsen Liu
  • Jing Yang
  • Shufang Wang
  • Xiangdong Wang
  • Hong Du
  • Jiangyun Meng
  • Hongbin Wang
  • Zhongsheng Lu
Original Article

Abstract

Objective

We aimed to evaluate the efficacy and safety of fully covered esophageal stent placement for preventing esophageal strictures after endoscopic submucosal dissection (ESD).

Methods

Twenty-two patients with a mucosal defects that exceeded 75 % of the circumference of the esophagus after ESD treatment for superficial esophageal squamous cell carcinomas were grouped according to the type of mucosal defect and randomized to undergo fully covered esophageal stent placement post-ESD (group A, n = 11) or no stent placement (group B, n = 11). In group A, the esophageal stents were removed 8 weeks post-ESD. Endoscopy was performed when patients reported dysphagia symptoms and at 12 weeks post-ESD in patients without symptoms. Savary–Gilliard dilators were used for bougie dilation in patients experiencing esophageal stricture in both groups, and we compared the rates of post-ESD strictures and the need for bougie dilation procedures.

Results

The proportion of patients who developed a stricture was significantly lower in group A (18.2 %, n = 2) than in group B (72.7 %, n = 8) (P < 0.05). Moreover, the number of bougie dilation procedures was significantly lower in group A (mean 0.45, range 0–3) than in group B (mean 3.9, range 0–17) (P < 0.05). The two patients in group A who experienced stricture also had stent displacement.

Conclusions

Esophageal stents are a safe and effective method of preventing esophageal strictures in cases where >75 % of the circumference of the esophagus has mucosal defects after ESD treatment for early esophageal cancer.

Keywords

Endoscopic submucosal dissection Esophageal cancer Esophageal stricture Esophageal stent Endoscopic bougie dilation 

Notes

Acknowledgment

This work was supported by Chinese Medical Sanitation Research Funds (11BJZ11).

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Jing Wen
    • 1
  • Yunsheng Yang
    • 1
  • Qingsen Liu
    • 1
  • Jing Yang
    • 1
  • Shufang Wang
    • 1
  • Xiangdong Wang
    • 1
  • Hong Du
    • 1
  • Jiangyun Meng
    • 1
  • Hongbin Wang
    • 1
  • Zhongsheng Lu
    • 1
  1. 1.Department of GastroenterologyChinese PLA General HospitalHaidian District, BeijingPeople’s Republic of China

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