title: Preventing stricture formation by covered esophageal stent placement after endoscopic submucosal dissection for early esophageal cancer.
abstract: OBJECTIVE
  We aimed to evaluate the efficacy and safety of fully covered esophageal stent placement for preventing esophageal strictures after endoscopic submucosal dissection (ESD).
  
  
  METHODS
  Twenty-two patients with a mucosal defects that exceeded 75 % of the circumference of the esophagus after ESD treatment for superficial esophageal squamous cell carcinomas were grouped according to the type of mucosal defect and randomized to undergo fully covered esophageal stent placement post-ESD (group A, n = 11) or no stent placement (group B, n = 11). In group A, the esophageal stents were removed 8 weeks post-ESD. Endoscopy was performed when patients reported dysphagia symptoms and at 12 weeks post-ESD in patients without symptoms. Savary-Gilliard dilators were used for bougie dilation in patients experiencing esophageal stricture in both groups, and we compared the rates of post-ESD strictures and the need for bougie dilation procedures.
  
  
  RESULTS
  The proportion of patients who developed a stricture was significantly lower in group A (18.2 %, n = 2) than in group B (72.7 %, n = 8) (P < 0.05). Moreover, the number of bougie dilation procedures was significantly lower in group A (mean 0.45, range 0-3) than in group B (mean 3.9, range 0-17) (P < 0.05). The two patients in group A who experienced stricture also had stent displacement.
  
  
  CONCLUSIONS
  Esophageal stents are a safe and effective method of preventing esophageal strictures in cases where >75 % of the circumference of the esophagus has mucosal defects after ESD treatment for early esophageal cancer.
authors: Department of Gastroenterology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, People's Republic of China, wenjingdudu@126.com.
authors: Jing
authors: J
authors: Wen
authors: Zhongsheng
authors: Z
authors: Lu
authors: Yunsheng
authors: Y
authors: Yang
authors: Qingsen
authors: Q
authors: Liu
authors: Jing
authors: J
authors: Yang
authors: Shufang
authors: S
authors: Wang
authors: Xiangdong
authors: X
authors: Wang
authors: Hong
authors: H
authors: Du
authors: Jiangyun
authors: J
authors: Meng
authors: Hongbin
authors: H
authors: Wang
authors: Enqiang
authors: E
authors: Linghu
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery*; D004940:Esophageal Stenosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D016629:Esophagectomy / Q000295:instrumentation / Q000379:methods*; D004945:Esophagoscopy; D004947:Esophagus / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D015607:Stents; D016896:Treatment Outcome