Managing esophageal strictures following endoscopic resection of superficial neoplastic lesions

Rev Esp Enferm Dig. 2021 Dec;113(12):810-812. doi: 10.17235/reed.2021.8437/2021.

Abstract

Over the last few years early esophageal tumors, whether squamous-cell or associated with Barrett's esophagus, have been excised using endoscopic resection techniques, primarily endoscopic submucosal dissection (ESD). Esophageal surgery-associated morbidity and mortality are thus avoided with similar oncologic outcomes. ESD is not without complications, many of which arise and are endoscopically solved during the procedure itself (bleeding, perforation, etc.). Other complications develop within days or weeks after resection, these including mainly esophageal stricture. Esophageal strictures following ESD are initially managed with endoscopic balloon dilation (EBD). Preventive measures have been suggested to alleviate this complication, primarily by using local or systemic steroids in association with early dilation. Even so, not always may they be prevented. Such complications are called refractory strictures, which require either esophageal stents (in a majority of cases) or surgery.

MeSH terms

  • Constriction, Pathologic
  • Endoscopic Mucosal Resection* / adverse effects
  • Esophageal Neoplasms* / pathology
  • Esophageal Neoplasms* / surgery
  • Esophageal Stenosis* / etiology
  • Esophageal Stenosis* / therapy
  • Humans
  • Retrospective Studies
  • Treatment Outcome