Background and Aims

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

Methods

Nine patients who underwent circumferential ESD for early esophageal cancer were enrolled. After the patients underwent ESD, autologous esophageal mucosal patches were attached to the ulcer surface by using hemoclips and were 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 days) after the procedure. The median number of endoscopic balloon dilatation 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 circumferential ESD.

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

背景和目标

食管狭窄是内镜下黏膜下剥离术（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。

方法

纳入9例接受早期食管癌周向ESD治疗的患者。患者接受ESD治疗后，使用止血钳将自体食道粘膜贴附在溃疡表面，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，移植物成活率为96.5％。手术后平均发生24.7天（18-34天不等）。内窥镜球囊扩张术的中位数为2.7（范围0-6）。

结论

自体食管粘膜移植可能是减轻周向ESD后食管狭窄严重程度的安全方法。