Backgroud and study aims

Esophageal stricture is a common adverse event after endoscopic submucosal dissection (ESD) when it involves entire circumference of esophagus. We aimed to assess the effectiveness and safety of endoscopic transplantation of autologous esophageal mucosa in preventing stricture formation after circumferential ESD.

Patients and methods

Nine patients who underwent circumferential ESD for early esophageal cancer were enrolled. After undergoing ESD, autologous esophageal mucosal patches were attached to the “ulcer surface” using hemoclips and 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.

Results

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) after the procedure. The median number of endoscopic balloon dilatation (EBD) sessions was 2.7 (range 0–6).

Conclusions

Transplantation of autologous esophageal mucosa could be a safe way of relieving the severity of esophageal stricture after cESD.

中文翻译：

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自体食管粘膜移植术预防早期食管癌周向内镜黏膜下剥离术后狭窄

背景和学习目标

食管狭窄是内镜下粘膜下剥离术（ESD）引起的常见不良事件，涉及食管的整个圆周。我们旨在评估内镜食管自体食管粘膜移植在预防周向ESD后狭窄形成方面的有效性和安全性。

患者和方法

纳入9例接受早期食管癌周向ESD治疗的患者。进行ESD后，使用止血钳将自体食道粘膜斑贴附到“溃疡表面”，然后用覆盖的金属网状支架固定。手术后7天将支架取出。在预定的时间对患者进行内窥镜检查。

结果

上皮化发生在中位数7.1天之内，移植物存活率为96.5％。手术后平均24.7天（范围18-34）发生了狭窄。内镜下球囊扩张术（EBD）的中位数为2.7（范围为0-6）。

结论

自体食管粘膜移植可能是缓解cESD后食管狭窄严重程度的安全方法。