ABSTRACT
Objective Few reports are seen comparing esophageal stent placement (ESP) and the endoscopic incision method (EIM) in the treatment refractory esophageal anastomotic strictures (EAS) following esophageal carcinoma resection (ECR). This study was to evaluate the effect ESP versus that of EIM in the treatment of refractory EAS after ECR. Methods We retrospectively analyzed the clinical data on 50 cases of post-ECR refractory EAS treated by ESP (n = 32) or EIM (n = 18) in our Center of Digestive Medicine between January 2012 and December 2018. We recorded and compared the pre- and post-operative dysphagia scores, post-operative complications and follow-up results between the two groups of patients. Results Compared with the EIM group, the patients of the ESP group had a remarkably lower dysphagia score post-operatively (1.4±0.5 vs 1.0±0.0, P<0.01), a smaller diameter of the dilated esophagus ([19.9±1.8] vs [11.0±1.9] mm, P<0.01), higher incidence rates mild and severe chest pain (P=0.022), and a higher rate of relief of esophageal stricture at 12 months after surgery (P<0.05). Conclusion EIM can rapidly relieve the symptoms of esophageal anastomotic stricture, while ESP may achieve a longer duration of relief. Both of the procedures are safe for patients with refractory esophageal anastomotic stricture.
ABSTRACT
Objective To assess the safety, efficacy and the clinical value of endoscopic treatment for duodenal lesions. Methods 59 patients with duodenal lesions were treated by endoscope from December 2012 to December 2016. The clinical data were retrospectively analyzed. Results There were 31 male and 28 female patients, aged 17 ～ 81 (58.2 ± 13.3) years. The lesion location included the duodenal bulb (n = 24, 40.68％) and the descending part (n = 21, 25.42％). The diameter of the lesions ranged from 0.2 to 5.0 (1.4 ± 0.9). Thirty-nine (66.10％) lesions originated from the mucosa, including inflammatory/hyperplastic polyps (n = 18, 30.51％), villous/tubular adenoma (n = 6, 10.17％). Twenty (33.90％) lesions originated from the submucosa, including Brunner's glands adenoma (n = 4, 6.78％), ectopic pancreas (n = 5, 8.47％), lipoma (n = 4, 6.78％). There were 4 delayed bleeding, 5 intraoperative perforation. Two patients received extended surgical resection later, and all the 59 patients showed no recurrence during the followed up (range, 3 ～ 30 months) using endoscopy. Conclusion Endoscopic treatment is a safe, effective, valuable method for the management of duodenal lesions.