Esophageal Stricture Prevention after Endoscopic Submucosal Dissection.

Area of Science:

• Gastroenterology
• Oncology
• Endoscopic Surgery

Background:

• Advances in diagnostics increase superficial esophageal cancer (SEC) detection.
• SEC are treatable with minimally invasive endoscopic techniques like endoscopic submucosal dissection (ESD).
• Esophageal stricture (ES) is a frequent and significant complication following ESD.

Purpose of the Study:

• To review methods for reducing esophageal stricture (ES) incidence after endoscopic submucosal dissection (ESD).
• To discuss the efficacy, techniques, and limitations of various preventative strategies for ES post-ESD.

Main Methods:

• Systematic review of case reports, prospective single-center studies, and randomized controlled trials.
• Analysis of interventions aimed at preventing esophageal stricture (ES) after endoscopic submucosal dissection (ESD).

Main Results:

• Steroids demonstrate consistent efficacy in reducing ES post-ESD with minimal complications.
• Systemic and local steroid delivery have distinct advantages and disadvantages.
• Emerging therapies like esophageal stents and cell sheet transplantation show promise but require further investigation.

Conclusions:

• Preventing esophageal stricture (ES) after endoscopic submucosal dissection (ESD) is crucial for patient outcomes.
• Steroids remain a primary therapeutic option for ES prevention post-ESD.
• Continued research into novel techniques is needed to further minimize ES incidence and morbidity.