Department of Gastroenterology, Xinqiao Hospital, Chongqing 400037, P.R. China.
Gastrointest Endosc. 2018 Sep;88(3):543-546. doi: 10.1016/j.gie.2018.04.2349. Epub 2018 Apr 25.
Esophageal stricture is a common adverse event after endoscopic submucosal dissection (ESD) when it involves the entire circumference of the esophagus. We aimed to assess the effectiveness and safety of endoscopic transplantation of autologous esophageal mucosa in preventing stricture formation after circumferential ESD.
Nine patients who underwent circumferential ESD for early esophageal cancer were enrolled. After the patients underwent ESD, autologous esophageal mucosal patches were attached to the ulcer surface by using hemoclips and were then fixed with a covered metal mesh stent. The stent was removed 7 days after the procedure. The patients were followed up with endoscopy at scheduled times.
Epithelialization occurred within a median of 7.1 days, with a graft survival rate of 96.5%. Strictures occurred at a mean of 24.7 days (range 18-34 days) after the procedure. The median number of endoscopic balloon dilatation sessions was 2.7 (range 0-6).
Transplantation of autologous esophageal mucosa could be a safe way of relieving the severity of esophageal stricture after circumferential ESD.
内镜黏膜下剥离术（ESD）累及食管全周时，常导致食管狭窄等并发症。本研究旨在评估自体食管黏膜移植在预防环形 ESD 术后狭窄形成中的有效性和安全性。
纳入 9 例行环形 ESD 治疗的早期食管癌患者。ESD 术后，应用血管夹将自体食管黏膜片固定于溃疡表面，再用覆膜金属支架覆盖。术后 7 天取出支架。定期行内镜随访。
中位上皮化时间为 7.1 天，移植物存活率为 96.5%。术后平均 24.7 天（18-34 天）出现狭窄，中位内镜球囊扩张次数为 2.7 次（0-6 次）。
自体食管黏膜移植可能是缓解环形 ESD 术后食管狭窄严重程度的一种安全方法。
