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01-10-2015

Complications of endoscopic dilation for esophageal stenosis after endoscopic submucosal dissection of superficial esophageal cancer

Authors: Yoshihiro Kishida, Naomi Kakushima, Noboru Kawata, Masaki Tanaka, Kohei Takizawa, Kenichiro Imai, Kinichi Hotta, Hiroyuki Matsubayashi, Hiroyuki Ono

Published in: Surgical Endoscopy | Issue 10/2015

Abstract

Background

Endoscopic dilation (ED) is used for the treatment of benign strictures caused by reflux esophagitis or anastomotic stenosis after esophagectomy. Esophageal stenosis is a major complication after endoscopic submucosal dissection (ESD) of large superficial esophageal cancer, but little is known regarding the incidence of complications of ED for stenosis caused by esophageal ESD.

Methods

This was a retrospective study conducted at a single institution. From September 2002 to December 2012, a total of 1,337 ED procedures were performed for stenosis after esophageal ESD in 121 patients. The incidence of complications of ED and related clinical characteristics were analyzed.

Results

The incidence of bleeding was 0.8 % (1/121) per patient and 0.07 % (1/1,337) per procedure. The incidence of perforation was 4.1 % (5/121) per patient and 0.37 % (5/1,337) per procedure. Perforation occurred at a median of third time of ED procedures (range 2–9 procedures) and at a median of 18 days (range 8–29 days) after ESD. There were no significant characteristics correlated to perforation, such as location, circumferential extent, or diameter of mucosal defect after ESD. The total number of ED procedures was significantly larger among perforation cases (37, range 6–57) compared with those without perforation (7, range 1–70) (p = 0.01), and the treatment duration tended to be longer (190 vs. 69 days, respectively).

Conclusions

The incidence of bleeding caused by ED for esophageal stenosis after ESD was very low. Relevant risk of perforation should be considered for patients requiring multiple ED procedures.

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Title: Complications of endoscopic dilation for esophageal stenosis after endoscopic submucosal dissection of superficial esophageal cancer
Authors: Yoshihiro Kishida
Naomi Kakushima
Noboru Kawata
Masaki Tanaka
Kohei Takizawa
Kenichiro Imai
Kinichi Hotta
Hiroyuki Matsubayashi
Hiroyuki Ono
Publication date: 01-10-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 10/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-014-4028-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Complications of endoscopic dilation for esophageal stenosis after endoscopic submucosal dissection of superficial esophageal cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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