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Related Concept Videos

Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

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Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
67
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

52
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
52
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

128
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
128
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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Barrett Esophagus-I: Introduction01:21

Barrett Esophagus-I: Introduction

75
Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
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Endoscopic Procedures II: Colonoscopy01:25

Endoscopic Procedures II: Colonoscopy

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The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
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Related Experiment Video

Updated: Jun 14, 2025

ADSC-sheet Transplantation to Prevent Stricture after Extended Esophageal Endoscopic Submucosal Dissection
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Risk Factors for Stricture After Endoscopic Submucosal Dissection of Large Rectal Neoplasms.

Daniel T Rezende1, Fabio S Kawaguti1,2, Cintia M S Kimura3,4

  • 1Division of Endoscopy, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil.

Diseases of the Colon and Rectum
|June 13, 2025
PubMed
Summary

Rectal strictures after endoscopic submucosal dissection are linked to large defects (≥90% circumference). Most symptomatic strictures resolved with dilation, highlighting a key risk factor and successful treatment strategy.

Keywords:
Early rectal cancerEndoscopic submucosal dissectionLaterally spreading tumorRectal endoscopic submucosal dissectionRectal stricture

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Endoscopic Procedures

Background:

  • Acute adverse events after endoscopic submucosal dissection (ESD), such as perforation and bleeding, are well-documented.
  • Studies focusing on post-ESD stricture are limited, necessitating further investigation into risk factors and outcomes.

Purpose of the Study:

  • To identify risk factors associated with rectal stricture and symptomatic stricture following ESD.
  • To evaluate patient outcomes, including treatment efficacy, in a Western tertiary cancer center.

Main Methods:

  • A single-center retrospective study utilizing a prospectively collected database of rectal ESD procedures.
  • Analysis included 94 patients who underwent ESD for rectal neoplasms between July 2010 and January 2020.
  • Risk factors for stricture development were assessed, with strictures classified as complete or partial.

Main Results:

  • Twenty out of 94 patients (21.3%) developed rectal strictures (13 complete, 7 partial).
  • Multivariable analysis identified a circumferential mucosal defect of ≥90% as the sole significant risk factor for stricture (p < 0.001).
  • Eleven of thirteen patients with complete stricture were symptomatic and successfully treated with serial dilations (mean 7.8 sessions).

Conclusions:

  • Extensive circumferential mucosal defects (≥90%) are a significant risk factor for rectal stricture after ESD.
  • Symptomatic rectal strictures following ESD can be effectively managed with endoscopic dilation.
  • This study provides valuable insights into managing post-ESD strictures in a Western population.