Abstract:
:Endoscopic resection has been the standard treatment for intramucosal esophageal cancers (ECs) because of the low risk of lymph node metastases in the lesions. In recent years, endoscopic submucosal dissection (ESD), which can resect large ECs, has been performed. However, the risk of esophageal stricture after ESD is high when the mucosal defect caused by the treatment exceeds 3/4 of the circumference of the lumen. Despite the subsequent high risk of luminal stricture, ESD has been performed even in cases of circumferential EC. In such cases, it is necessary to take measures to prevent stricture. Therefore, in this review, we aimed to clarify the current status of stricture prevention methods after esophageal ESD based on previous literature. Although various prophylactic methods have been reported to have stricture-preventing effects, steroid injection therapy and oral steroid administration are mainstream. However, in cases of circumferential EC, both steroid injection therapy and oral steroid administration cannot effectively prevent luminal stricture. To solve this issue, clinical applications, such as tissue shielding methods with polyglycolic acid sheet, autologous oral mucosal epithelial sheet transplantation, and stent placement, have been developed. However, effective prophylaxis of post-ESD mucosal defects of the esophagus is still unclear. Therefore, further studies in this research field are needed.
journal_name
J Clin Medjournal_title
Journal of clinical medicineauthors
Hikichi T,Nakamura J,Takasumi M,Hashimoto M,Kato T,Kobashi R,Takagi T,Suzuki R,Sugimoto M,Sato Y,Irie H,Okubo Y,Kobayakawa M,Ohira Hdoi
10.3390/jcm10010020subject
Has Abstractpub_date
2020-12-23 00:00:00issue
1issn
2077-0383pii
jcm10010020journal_volume
10pub_type
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