Outcome of a novel self-control stricture-preventing water balloon for complete circular esophageal endoscopic submucosal dissection

Surg Endosc. 2023 Jan;37(1):290-297. doi: 10.1007/s00464-022-09456-8. Epub 2022 Aug 5.

Abstract

Objectives: Post-ESD esophageal stricture especially after wholly circumferential ESD remains an unresolved issue without ideal strategies. Our initiative novel self-control stricture-preventing water balloon may be an alternative.

Methods: Patients with esophageal neoplastic lesions expected to result in a whole circular mucosa defect after esophageal ESD from February 2018 to August 2020 were included in the study. We used a novel self-control stricture-preventing water balloon combined with oral prednisolone as preventive strategy for the enrolled patients.

Results: Thirty-seven patients (9 females and 28 males, patients aged 52 to 82 years) finished the 12-week treatment including steroid treatment and balloon placement. The median size of longitudinal diameter was 7 cm (range from 4 to 14 cm). All the lesions achieved curative resection and the median procedure time was 110 min (range 50 to 180 min). Balloons were found migration in 4 patients. As a result, there were 3 patients (8.1%) experienced stricture. Generally, patients could tolerate to balloons, only with mild uncomfortableness, such as occasional sore throat, cough, and retrosternal pain. In addition, during the follow-up period, no significant adverse events associated to oral steroid administration were observed and no recurrence was found.

Conclusions: Our novel self-control stricture-preventing water balloon based on the oral steroid therapy is effective and safe. This strategy well prevents esophageal stricture after complete circumferential ESD.

Keywords: Complete circular; Endoscopic submucosal dissection; Preventing; Stricture.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Constriction, Pathologic / etiology
  • Endoscopic Mucosal Resection* / adverse effects
  • Endoscopic Mucosal Resection* / methods
  • Esophageal Neoplasms* / pathology
  • Esophageal Stenosis* / etiology
  • Esophageal Stenosis* / prevention & control
  • Female
  • Humans
  • Male
  • Self-Control*
  • Steroids

Substances

  • Steroids