Prophylactic Stenting to Decrease the Incidence of Esophageal Strictures after Extensive Endoscopic Submucosal Dissection: the First U.S. Experience.

Endoscopic submucosal dissection (ESD) allows en bloc resection of early esophageal adenocarcinomas and squamous cell carcinomas. However, this technique is not without shortcomings. When the resected area is ≥5 cm in length, strictures are common, and with circumferential resections (CRs), stricture formation is almost universal. 1 Bhatt A. Mehta N.A. Stricture prevention after esophageal endoscopic submucosal dissection. Gastrointest Endosc. 2020; 92: 1187-1189 Abstract Full Text Full Text PDF PubMed Google Scholar Some theories behind this phenomenon include formation of granulation tissue, horizontally oriented myofibroblasts, dense collagen tissue, and atrophy of the muscularis propria. These strictures tend to be recalcitrant, and their treatment carries risks of adverse events. 1 Bhatt A. Mehta N.A. Stricture prevention after esophageal endoscopic submucosal dissection. Gastrointest Endosc. 2020; 92: 1187-1189 Abstract Full Text Full Text PDF PubMed Google Scholar ,2 Takahashi H. Arimura Y. Okahara S. et al. Risk of perforation during dilation for esophageal strictures after endoscopic resection in patients with early squamous cell carcinoma. Endoscopy. 2011; 43: 184-189 Crossref PubMed Scopus (80) Google Scholar