Risk factors of esophageal stricture after endoscopic resection of large-area early esophageal cancer / 中华消化内镜杂志

ABSTRACT

Objective:To explore the risk factors for esophageal stricture after endoscopic resection (ER) of large-area early esophageal cancer (≥3/4 circumferential mucosal defect).Methods:A total of 63 cases of large-area early esophageal cancer treated with ER in the Digestive Endoscopy Center of the First Medical Center of PLA General Hospital from May 2009 to April 2016 were included in the retrospective analysis. They were divided into stricture group (32 cases) and non-stricture group (31 cases) according to the occurrence of postoperative esophageal stenosis. T-test or Chi square test was conducted to compare the indicators between the two groups. Indicators of P<0.05 and potential indicators from the clinical perspective were included in multivariate logistic regression analysis. Results:Univariate analysis showed that the length of lesion, the degree of mucosal defect around the wound and the injury of muscularis propria were associated with esophageal stricture after ER ( P<0.05). The above 3 indicators were included in the multivariate logistic regression analysis, together with 3 other indicators, i. e. preventive measures for stenosis, pathological type, and en bloc resection. The results showed that more than 7/8 circumferential mucosal defect around the wound (VS 3/4-<7/8 circumferential P=0.028, OR=0.317, 95% CI0.114-0.884) and no preventive measures ( P=0.002, OR=0.153, 95% CI0.046-0.512) were independent risk factors for esophageal stricture after ER of large-area early esophageal cancer. Conclusion:Circumferential mucosa defect≥7/8 is the main factor leading to esophagus stricture after large-area early esophagus carcinoma. And appropriate preventive measures can effectively reduce the incidence of postoperative stenosis after ER.