Utility of modified endoscopic radial incision and selective cutting combined with short-term stenting for refractory stricture in patients undergoing endoscopic submucosal dissection of superficial esophageal carcinoma
Background: Refractory esophageal stricture is the common complication of extensive endoscopic submucosal dissection (ESD), without satisfactory endoscopic treatment strategies. We evaluated the efficacy, safety, and long-term patency of the modified endoscopic radial incision and selective cutting...
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| Format: | Article |
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SAGE Publishing
2025-01-01
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| Series: | Therapeutic Advances in Gastroenterology |
| Online Access: | https://doi.org/10.1177/17562848251315416 |
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| author | Lu Chen Xiajiao Tang Jingjing Jiang XiaoChun Yin Yuxin Wang Mingyue Li Ruihua Shi |
| author_facet | Lu Chen Xiajiao Tang Jingjing Jiang XiaoChun Yin Yuxin Wang Mingyue Li Ruihua Shi |
| author_sort | Lu Chen |
| collection | DOAJ |
| description | Background: Refractory esophageal stricture is the common complication of extensive endoscopic submucosal dissection (ESD), without satisfactory endoscopic treatment strategies. We evaluated the efficacy, safety, and long-term patency of the modified endoscopic radial incision and selective cutting combined with short-term stenting (RISC-STS) for the treatment of refractory esophageal stenosis. Methods: This was a retrospective study. Patients diagnosed with refractory esophageal stricture from June 2016 to June 2023 were enrolled. Efficacy, safety, and risk factors for dysphagia after RISC-STS operation were assessed. Results: Compared with clinical symptoms before RISC-STS, there was no significant improvement in the times of stricture recurred ( p = 0.75). However, the narrowest diameter of esophageal stenosis was significantly larger after RISC-STS treatment ( p = 0.04). Corresponding dysphagia scores after RISC-STS were obviously lowered according to the Mellow–Pinkas grading scale ( p = 0.002). More cases ((14 (60.87%) vs 5 (21.74%)) received valid symptom-relief periods after RISC-STS ( p = 0.0004). The complications of RISC-STS include perforation (4.35%), fever (4.35%), and pain (30.43%). Univariate Cox analysis suggested that resection length >7 cm of scar tissue was a risk factor for refractory dysphagia after RISC-STS. Conclusion: The present study revealed that RISC-STS is an effective and safe technique for refractory esophageal stricture with lower restenosis, higher valid symptom-relief rate, and fewer complications. |
| format | Article |
| id | doaj-art-9ae1101ff07541f7993c6b9c47d065f5 |
| institution | Kabale University |
| issn | 1756-2848 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Gastroenterology |
| spelling | doaj-art-9ae1101ff07541f7993c6b9c47d065f52025-01-31T12:04:55ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482025-01-011810.1177/17562848251315416Utility of modified endoscopic radial incision and selective cutting combined with short-term stenting for refractory stricture in patients undergoing endoscopic submucosal dissection of superficial esophageal carcinomaLu ChenXiajiao TangJingjing JiangXiaoChun YinYuxin WangMingyue LiRuihua ShiBackground: Refractory esophageal stricture is the common complication of extensive endoscopic submucosal dissection (ESD), without satisfactory endoscopic treatment strategies. We evaluated the efficacy, safety, and long-term patency of the modified endoscopic radial incision and selective cutting combined with short-term stenting (RISC-STS) for the treatment of refractory esophageal stenosis. Methods: This was a retrospective study. Patients diagnosed with refractory esophageal stricture from June 2016 to June 2023 were enrolled. Efficacy, safety, and risk factors for dysphagia after RISC-STS operation were assessed. Results: Compared with clinical symptoms before RISC-STS, there was no significant improvement in the times of stricture recurred ( p = 0.75). However, the narrowest diameter of esophageal stenosis was significantly larger after RISC-STS treatment ( p = 0.04). Corresponding dysphagia scores after RISC-STS were obviously lowered according to the Mellow–Pinkas grading scale ( p = 0.002). More cases ((14 (60.87%) vs 5 (21.74%)) received valid symptom-relief periods after RISC-STS ( p = 0.0004). The complications of RISC-STS include perforation (4.35%), fever (4.35%), and pain (30.43%). Univariate Cox analysis suggested that resection length >7 cm of scar tissue was a risk factor for refractory dysphagia after RISC-STS. Conclusion: The present study revealed that RISC-STS is an effective and safe technique for refractory esophageal stricture with lower restenosis, higher valid symptom-relief rate, and fewer complications.https://doi.org/10.1177/17562848251315416 |
| spellingShingle | Lu Chen Xiajiao Tang Jingjing Jiang XiaoChun Yin Yuxin Wang Mingyue Li Ruihua Shi Utility of modified endoscopic radial incision and selective cutting combined with short-term stenting for refractory stricture in patients undergoing endoscopic submucosal dissection of superficial esophageal carcinoma Therapeutic Advances in Gastroenterology |
| title | Utility of modified endoscopic radial incision and selective cutting combined with short-term stenting for refractory stricture in patients undergoing endoscopic submucosal dissection of superficial esophageal carcinoma |
| title_full | Utility of modified endoscopic radial incision and selective cutting combined with short-term stenting for refractory stricture in patients undergoing endoscopic submucosal dissection of superficial esophageal carcinoma |
| title_fullStr | Utility of modified endoscopic radial incision and selective cutting combined with short-term stenting for refractory stricture in patients undergoing endoscopic submucosal dissection of superficial esophageal carcinoma |
| title_full_unstemmed | Utility of modified endoscopic radial incision and selective cutting combined with short-term stenting for refractory stricture in patients undergoing endoscopic submucosal dissection of superficial esophageal carcinoma |
| title_short | Utility of modified endoscopic radial incision and selective cutting combined with short-term stenting for refractory stricture in patients undergoing endoscopic submucosal dissection of superficial esophageal carcinoma |
| title_sort | utility of modified endoscopic radial incision and selective cutting combined with short term stenting for refractory stricture in patients undergoing endoscopic submucosal dissection of superficial esophageal carcinoma |
| url | https://doi.org/10.1177/17562848251315416 |
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