Clinical value of autologous skin-grafting surgery to prevent esophageal stenosis after complete circular endoscopic submucosal tunnel dissection for early esophageal cancer

Abstract

Objective To assess the efficacy and safety of autologous skin-grafting surgery (ASGS) in the prevention of esophageal stenosis after complete circular endoscopic submucosal tunnel dissection (ESTD) for early esophageal cancer. Methods Between January 2018 and March 2018, five patients with early esophageal cancer underwent complete circular ESTD and ASGS in Chinese PLA General Hospital. The skin-graft survival situation, and occurrence of esophageal stenosis and complications were observed by endoscopy follow-up. Results Complete circular ESTD and ASGS were successfully performed in all 5 patients, and no complications including perforation, bleeding, wound infection or stent migration occurred. The mean skin-graft survival rate was 86.0%. Four patients did not experience esophageal stenosis over the mean follow-up of 9.5 months. One patient experienced esophageal stenosis after operation, and underwent endoscopic balloon dilatation.No stenosis occurred in 8 months of follow-up. Conclusion ASGS is a safe and effective method to prevent esophageal stenosis after complete circular ESTD Key words: Esophageal stenosis; Transplantation, autologous; Efficacy; Safety; Early esophageal cancer; Endoscopic submucosal tunnel dissection