Risk factors of esophageal stricture after endoscopic submucosal dissection for early stage esophageal cancer

Abstract

Objective To analyze the risk factors for postoperative stricture after endoscopic submucosal dissection （ESD） for early stage esophageal cancer. Methods The data of 362 patients with early esophageal cancer treated by ESD from January 2007 to February 2012 were reviewed to investigate the risk factors of postoperative stricture. Results Esophageal stricture after ESD occurred in 42 patients （ 11.6% ） with a mean time from ESD to stricture of （58.5±12. 3） days. The rates of mild, median and severe stricture were 16.7% （7/42） , 38.1% （16/42） and 45.2% （ 19/42）, respectively. Multivariate analysis revealed that lesion range 〉 3/4 esophageal circumference （odds ration [OR] ： 44.2; 95% confidence interval [CI] ： 4.4-443.6） and tumor invasion beyond m2 （ OR： 14.2; 95% CI： 2.7-74.2） were independent risk factors. Stricture level was related to lesion＇s circumferential extension （relational coefficient φ = 0. 47, P 〈 0. 05 ） and tumor invasion depth （ relational coefficient φ= 0. 647, P 〈 0. 05 ）. Conclusion Circumferential extension and invasion depth of early esophageal cancer were independent risk factors for post-ESD esophageal stricture and related with the degree of stricture. Key words: Postoperative stricture; Risk factors; Early esophageal cancer; Endoscopic submucosal dissection