Medical School of The People's Liberation Army (PLA), Beijing, China; Department of Gastroenterology and Hepatology, The First Medical Centre, The People's Liberation Army (PLA) General Hospital, Beijing, China.
Department of Gastroenterology and Hepatology, The First Medical Centre, The People's Liberation Army (PLA) General Hospital, Beijing, China.
Turk J Gastroenterol. 2022 Oct;33(10):811-821. doi: 10.5152/tjg.2022.22298.
The incidence of esophageal stricture without stricture prophylaxis measures after whole circumferential endoscopic resection is almost 100%, which substantially decreases the patients' quality of life and requires multiple sessions of endoscopic balloon dilation. To date, there are many reports concerning the prevention of esophageal stricture after whole circumferential endoscopic resection. Oral steroid may be effective for preventing esophageal stricture after whole circumferential endoscopic resection. However, exposure to a high dose of steroid raises concerns with regard to adverse events. Intralesional triamcinolone acetonide injection and preventive endoscopic balloon dilation did not appear to reduce the frequency of stricture formation after whole circumferential endoscopic resection. Esophageal stent appeared to be a possible prophylactic treatment, but adverse events should be of great concern. Polyglycolic acid sheets seemed promising, because they can not only act as protective barriers but can also be drug carriers to prevent esophageal stricture. Tissue engineering and regenerative medicine such as oral mucosal epithelial cell sheets cultured in vitro have been used in patients to prevent esophageal stricture, but it is technically and financially burdensome. Autologous tissue transplantation showed a promising preventive effect for esophageal stricture and it is relatively easy to carry out in clinical practice, and this technique needs further improvements to prevent esophageal stricture after whole circumferential endoscopic resection.
食管全周内镜切除术后未采取狭窄预防措施的狭窄发生率几乎为 100%，这极大地降低了患者的生活质量，并需要多次进行内镜球囊扩张。迄今为止，已有许多关于食管全周内镜切除术后预防狭窄的报道。口服类固醇可能对预防食管全周内镜切除术后狭窄有效。然而，接触高剂量类固醇会引起对不良事件的担忧。腔内曲安奈德注射和预防性内镜球囊扩张似乎并未降低全周内镜切除术后狭窄形成的频率。食管支架似乎是一种可能的预防治疗方法，但应高度关注不良事件。聚乙二醇酸片似乎很有前途，因为它们不仅可以作为保护屏障，还可以作为药物载体来预防食管狭窄。组织工程和再生医学，如体外培养的口腔黏膜上皮细胞片，已用于预防食管狭窄，但在技术和经济上都很繁琐。自体组织移植对食管狭窄显示出有希望的预防效果，并且在临床实践中相对容易实施，该技术需要进一步改进，以预防食管全周内镜切除术后狭窄。
