Digestive Endoscopy Department, The First Affiliated Hospital with Nanjing Medical University, China.
Department of Stomatology, The First Affiliated Hospital with Nanjing Medical University, China.
Endoscopy. 2018 Oct;50(10):1017-1021. doi: 10.1055/a-0622-8019. Epub 2018 Jun 11.
Esophageal caustic stricture is a stubborn disease and postoperative restenosis limits the clinical efficacy of endoscopic dilation. Autologous mucosal grafts have been successfully applied in the treatment of urethral stricture and in the prevention of stricture after extensive mucosal resection. We aimed to use mucosal autografting performed endoscopically to treat refractory esophageal stricture. METHODS : Three patients with intractable corrosive esophageal stricture were treated endoscopically by combining dilation with autologous mucosal transplantation. RESULTS : All procedures were successful with no severe complications. Mucosal regeneration was shown at the transplanted segments. One patient was able to maintain a normal diet with complete remission after 1 year of follow-up. Intraluminal stenosis and dysphagia were significantly improved in another two patients. CONCLUSIONS : Mucosal autografting can achieve esophageal re-epithelialization, inhibit undesired fibrosis, prevent restenosis, and promote functional regeneration.
食管腐蚀性狭窄是一种顽症,术后再狭窄限制了内镜扩张的临床疗效。自体黏膜移植已成功应用于尿道狭窄的治疗和广泛黏膜切除术后狭窄的预防。我们旨在使用内镜下黏膜自体移植治疗难治性食管狭窄。方法:对 3 例难治性腐蚀性食管狭窄患者采用内镜扩张联合自体黏膜移植治疗。结果:所有手术均成功,无严重并发症。移植段显示黏膜再生。1 例患者在随访 1 年后能维持正常饮食,完全缓解。另外 2 例患者腔内狭窄和吞咽困难明显改善。结论:黏膜自体移植可实现食管再上皮化,抑制非期望性纤维化,防止再狭窄,促进功能再生。