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Metal stenting to resolve post-photodynamic therapy stricture in early esophageal cancer

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World Journal of Gastroenterology 2011年第10期17卷 1379-1382页

作者： Young Koog Cheon Division of Gastroenterology Department of Internal MedicineKonKuk University School of Medicine

Photodynamic therapy (PDT) is an established endoscopic technique for ablating Barrett's esophagus with high-grade dysplasia or early-stage intraepithelial neoplasia. The most common clinically significant adverse effect of PDT is esophageal stricture formation. The strictures are usually superficial and might be dilated effectively with standard endoscopic accessories, such as endoscope balloon or Savary dilators. However, multiple dilations might be required to achieve stricture resolution in some cases. We report the case of stricture that recurred after dilation with a bougie, which was completely relieved by a self-expandable metal stent.

关键词： Photodynamic therapy esophageal stricture Metal stent

Isolated esophageal Crohn’s Disease with Diffuse stricture

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Open Journal of Thoracic Surgery 2021年第4期11卷 96-106页

作者： Mohamed Alhaj Moustafa Department of General and Thoracic Surgery IDA Hospital Aleppo Syria

Background: esophageal strictures are considered to be one of the most challenging matters for gastroenterologist, general and thoracic surgeons in diagnosis and management. They can be grouped into three general cate... 详细信息

Background: Esophageal strictures are considered to be one of the most challenging matters for gastroenterologist, general and thoracic surgeons in diagnosis and management. They can be grouped into three general categories: intrinsic diseases, extrinsic diseases, and diseases that disrupt esophageal peristalsis and/or lower esophageal sphincter (LES) function. Crohn’s disease (CD) is a very rare cause of esophageal stricture. The prevalence of esophageal CD ranges from 1% to 2% in adults with CD. It is almost diagnosed lately when complications have occurred as Strictures, fissures, esophagobronchial fistulas, and mediastinal abscesses. Case Report: Thirty-nine years old Kurdish patient, referred to our department for evaluation. Although many consultations during the last two years, the Pt was still undiagnosed. She had progressive dysphagia, and weight loss of about 25 kg. She had no other digestive or extra digestive complaint, nor caustic ingestion history and nor drug history. Chest CT scan and UGI Contrast study revealed diffuse smooth an

关键词： Isolated esophageal Crohn’s Disease Crohn’s Disease esophageal stricture

Prevention of esophageal strictures after endoscopic submucosal dissection

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World Journal of Gastroenterology 2014年第41期20卷 15098-15109页

作者： Shinichiro Kobayashi Nobuo Kanai Takeshi Ohki Ryo Takagi Naoyuki Yamaguchi Hajime Isomoto Yoshiyuki Kasai Takahiro Hosoi Kazuhiko Nakao Susumu Eguchi Masakazu Yamamoto Masayuki Yamato Teruo Okano Institute of Advanced Biomedical Engineering and Science Tokyo Women’s Medical University Department of Surgery Nagasaki University Graduate School of Biomedical Sciences Department of Surgery Institute of GastroenterologyTokyo Women’s Medical University Department of Gastroenterology and Hepatology Nagasaki University Graduate School of Biomedical Sciences Graduate School of Advanced Science and Engineering Life Science and Medical BioscienceWaseda University Department of Pharmaceutical Sciences Graduate School of Pharmaceutical SciencesTokyo University of Science

Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have recently been accepted as less invasive methods for treating patients with early esophageal cancers such as squamous cell carcinoma and dysplasia of Barrett’s esophagus. However, the large defects in the esophageal mucosa often cause severe esophageal strictures, which dramatically reduce the patient’s quality of life. Although preventive endoscopic balloon dilatation can reduce dysphagia and the frequency of dilatation, other approaches are necessary to prevent esophageal strictures after ESD. This review describes several strategies for preventing esophageal strictures after ESD, with a particular focus on anti-inflammatory and tissue engineering approaches. The local injection of triamcinolone acetonide and other systemic steroid therapies are frequently used to prevent esophageal strictures after ESD. Tissue engineering approaches for preventing esophageal strictures have recently been applied in basic research studies. Scaffolds with temporary stents have been applied in five cases, and this technique has been shown to be safe and is anticipated to prevent esophageal strictures. Fabricated autologous oral mucosal epithelial cell sheets to cover the defective mucosa similarly to how commercially available skin products fabricated from epidermal cells are used for skin defects or in cases of intractable ulcers. Fabricated autologous oral-mucosal-epithelial cell sheets have already been shown to be safe.

关键词： Endoscopic submucosal dissection esophageal stricture Systemic steroid therapy Autologous oral mucosal epithelial cell sheet

esophageal strictures during Treatment with a Proton Pump Inhibitor

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Open Journal of Pediatrics 2015年第1期5卷 1-6页

作者： Einar Arnbjornsson Torbjorn Backman Department of Pediatric Surgery Skane University HospitalLundSweden The Institution of Clinical Research Lund UniversityLundSweden

Background: The development of esophageal stricture during treatment with high dose chemotherapeutic agents is well known and documented in the literature. With the introduction of proton pumps inhibitors (PPI), the gastroesophageal reflux disease (GERD) induced stricture has shown significant improvement. The aim of this report is to remind of the fact that the chemotherapy induced strictures show poor response and their treatment is still a challenge. Case presentation: Here, we reported a boy with Down syndrome and congenital heart disease who developed acute lymphoblastic leukemia and subsequent esophageal stricture during treatment with a PPI. Conclusion: It is important to be aware of this potential complication of gastroesophageal reflux or antineoplastic treatment, even in cases thought to be adequately treated with a proton pump inhibitor, and that the start of PPI’s is also the start of an evaluation of the use of this medication.

关键词： Gastroesophageal Reflux(GER) Omeprazole Esophagitis esophageal stricture Proton Pump Inhibitor(PPI) An Antineoplastic Treatment

Predictors of outcomes of endoscopic balloon dilatation in strictures after esophageal atresia repair: A retrospective study

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World Journal of Gastroenterology 2020年第10期26卷 1080-1087页

作者： Dong-Ling Dai Chen-Xi Zhang Yi-Gui Zou Qing-Hua Yang Yu Zou Fei-Qiu Wen Department of Gastroenterology Shenzhen Children’s Hospital

BACKGROUND Endoscopic balloon dilatation (EBD) has become the first line of therapy for benign esophageal strictures (ESs);however,there are few publications about the predictive factors for the outcomes of this *** To assess the predictive factors for the outcomes of EBD treatment for strictures after esophageal atresia (EA) *** Children with anastomotic ES after thoracoscopic esophageal atresia repair treated by EBD from January 2012 to December 2016 were *** procedures were performed under tracheal intubation and intravenous anesthesia using a three-grade controlled radial expansion balloon with *** were recorded and predictors of the outcomes were *** A total of 64 patients were included in this *** rates of response,complications,and recurrence were 96.77%,8.06%,and 2.33%,*** number of dilatation sessions and complications were significantly higher in patients with a smaller stricture diameter (P=0.013 and 0.023,respectively) and with more than one stricture (P=0.014 and 0.004,respectively).The length of the stricture was significantly associated with complications of EBD (P=0.001).A longer interval between surgery and the first dilatation was related to more sessions and a poorer response (P=0.017 and 0.024,respectively).CONCLUSION The diameter,length,and number of strictures are the most important predictive factors for the clinical outcomes of endoscopic balloon dilatation in pediatric *** interval between surgery and the first EBD is another factor affectingresponse and the number of sessions of dilatation.

关键词： Children Endoscopic balloon dilatation esophageal stricture Outcome Predictor

esophageal dilations in eosinophilic esophagitis: A single center experience

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World Journal of Gastroenterology 2014年第28期20卷 9549-9555页

作者： Andrew Ukleja Jennifer Shiroky Amitesh Agarwal Daniela Allende Department of Gastroenterology Cleveland Clinic Florida the University of Texas Medical Branch at Galveston Cleveland Clinic

AIM: To diagnose the clinical and histologic features that may be associated with or predictive of the need for dilation and dilation related complications; examine the safety of dilation in patients with eosinophilic... 详细信息

关键词： Balloon dilation Dysphagia Esophagus disorder esophageal stricture Esosinophilic esophagitis

Factors associated with complicated erosive esophagitis: A Japanese multicenter, prospective, cross-sectional study

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World Journal of Gastroenterology 2017年第2期23卷 318-327页

作者： Masahiro Sakaguchi Noriaki Manabe Nobuo Ueki Jun Miwa Tomoki Inaba Norimasa Yoshida Kouichi Sakurai Masahiro Nakagawa Hajime Yamada Michiya Saito Koji Nakada Katsuhiko Iwakiri Takashi Joh Ken Haruma Department of Gastroenterology Moriguchi Keijinkai Hospital Division of Endoscopy and Ultrasonography Department of Clinical Pathology and Laboratory MedicineKawasaki Medical School Department of Internal Gastroenterology and Hepatology Tokyo Rosai Hospital Department of Gastroenterology Toshiba General Hospital Department of Gastroenterology Kagawa Prefectural Central Hospital Department of Gastroenterology Japanese Red Cross Kyoto Daiichi Hospital Hattori Clinic Department of Endoscopy Hiroshima City Hospital Department of Gastroenterology and Hepatology Shinko Hospital1 Michiya Clinic1 Department of Laboratory Medicine Daisan Hospital Jikei University School of Medicine1 Department of Gastroenterology Nippon Medical School Graduate School of Medicine1 Department of Gastroenterology and Metabolism Nagoya City University Graduate School of Medical Sciences1 Department of General Internal Medicine 2 Kawasaki Medical School General Medical Center

AIMTo assess the clinical characteristics of patients with complicated erosive esophagitis (EE) and their associated *** prospective, cross-sectional study included patients diagnosed with EE by upper gastrointestinal endoscopy between October 2014 and March 2015 at 106 Japanese hospitals. Data on medical history, general condition, gastrointestinal symptoms, lifestyle habits, comorbidities, and endoscopic findings were collected using a standard form to create a dedicated database. Logistic regression analysis was used to calculate adjusted odds ratios (aOR) and 95%CI for the association with complicated *** the study period, 1749 patients diagnosed with EE, 38.3% of whom were prescribed proton pump inhibitors (PPIs) were included. Of them, 143 (8.2%) had EE complications. esophageal bleeding occurred in 84 (4.8%) patients, esophageal strictures in 45 (2.6%) patients, and 14 (0.8%) patients experienced both. Multivariate analysis showed that increased age (aOR: 1.05; 95%CI: 1.03-1.08), concomitant use of psychotropic agents (aOR: 6.51; 95%CI: 3.01-13.61), and Los Angeles grades B (aOR: 2.69; 95%CI: 1.48-4.96), C (aOR: 15.38; 95%CI: 8.62-28.37), and D (aOR: 71.49; 95%CI: 37.47-142.01) were significantly associated with complications, whereas alcohol consumption 2-4 d/wk was negatively associated (aOR: 0.23; 95%CI: 0.06-0.61). Analyzing associated factors with each EE complication separately showed esophageal ulcer bleeding were associated with increased age (aOR: 1.05; 95%CI: 1.02-1.07) and Los Angeles grades B (aOR: 3.60; 95%CI: 1.52-8.50), C (aOR: 27.61; 95%CI: 12.34-61.80), and D (aOR: 119.09; 95%CI: 51.15-277.29), while esophageal strictures were associated with increased age (aOR: 1.07; 95%CI: 1.04-1.10), gastroesophageal reflux symptom (aOR: 2.51; 95%CI: 1.39-4.51), concomitant use of psychotropic agents (aOR: 11.79; 95%CI: 5.06-27.48), Los Angeles grades C (aOR: 7.35; 95%CI: 3.32-16.25), and D (aOR: 20.34; 95%CI: 8.36-49.53) and l

关键词： Complication Erosive esophagitis Proton pump inhibitor esophageal ulcer bleeding esophageal stricture

Superior mesenteric artery syndrome in a patient with esophageal stenosis: A case report

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World Journal of Surgical Procedures 2022年第2期12卷 13-19页

作者： Luise Cristina Torres Rubim de Barros Barbara Moreira Ribeiro Trindade dos Santos Gustavo de Sousa Arantes Ferreira Vitoria Mikaelly da Silva Gomes Lorenna Paulinelli Bahia Vieira Department of General Surgery Hospital de Clinicas da Universidade Federal de Minas GeraisBelo Horizonte 31710350Minas GeraisBrazil Department of Liver Transplantation Instituto de Cardiologia do Distrito FederalBrasilia 70658-700Distrito FederalBrazil Department of General Surgery Hospital Metropolitano Doutor Celio de CastroBelo Horizonte 30620090Minas GeraisBrazil

BACKGROUND Superior mesenteric artery syndrome(SMAS)is a rare condition,characterized by duodenal obstruction caused by compression of its third part by the superior mesenteric artery(SMA).Most cases of SMAS are associated with weight loss,and the most frequent clinical manifestations are nausea,vomiting,postprandial fullness,and abdominal *** of SMAS is usually conservative,consisting mainly of adequate nutritional support,but in refractory cases surgery may be necessary,with gastrojejunostomy and duodenojejunostomy being the most commonly performed *** SUMMARY We describe the case of a man in his forties with a pre-existing diagnosis of esophageal stricture due to sodium hydroxide ingestion,who suffered significant weight loss after replacement of his jejunostomy *** was admitted to the hospital due to pain and abdominal distension.A computerized tomography scan showed significant distension of the stomach and duodenum with narrowing of the duodenum at the point at which it is crossed by the superior mesenteric artery,thus establishing the diagnosis of *** to the presence of the esophageal stricture,the patient was incapable of emesis;however,passage of a nasogastric tube for decompression was not *** the risk of gastric perforation due to distention,we opted for surgical treatment in the form of a surgical gastrojejunostomy after which he showed complete resolution of all symptoms and was discharged from the hospital 5 d after the *** Diagnosis of SMAS can be challenging in patients with esophageal stenosis,and risk of gastric perforation may preclude conservative treatment.

关键词： Superior mesenteric artery syndrome Duodenal obstruction Wilkie’s syndrome esophageal stricture esophageal stenosis Case report

Predictors of stricture after endoscopic submucosal dissection of the esophagus and steroids application

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World Journal of Gastrointestinal Endoscopy 2024年第9期16卷 509-518页

作者： Qing-Xia Wang Yuan Ding Qi-Liu Qian Yin-Nan Zhu Rui-Hua Shi Department of Gastroenterology Southeast University Affiliated Zhongda HospitalMedical SchoolNanjing 210009Jiangsu ProvinceChina

BACKGROUND Endoscopic submucosal dissection(ESD)is a reliable method to resect early esophageal *** stricture is one of the major complications after ESD of the *** prophylaxis for esophageal strictures,particularly local injection of triamcinolone acetonide(TA),is a relatively effective method to prevent esophageal ***,even with steroid prophylaxis,stenosis still occurs in up to 45%of *** the risk of stenosis formation after local TA injection would enable additional interventions in risky *** To identify the predictors of esophageal strictures after steroids *** Patients who underwent esophageal ESD and steroid prophylaxis and who were comprehensively assessed for lesion-and ESD-related factors at Southeast University Affiliated Zhongda Hospital between February 2018 and March 2023 were included in the *** univariate and multivariate regression analyses were conducted to identify the predictors of stricture among patients undergoing steroid *** A total of 120 patients were included in the *** the oral prednisone and oral prednisone combined with local tretinoin injection groups,the stenosis rates were 44/53(83.0%)and 56/67(83.6%),*** them,univariate analysis showed that the lesion circumference(P=0.01)and submucosal injection solution(P=0.04)showed significant correlation with the risk of stenosis *** regression analyses were then performed using predictors that were significant in the univariate analyses and combined with known predictors from previous reports,such as additional chemoradiotherapy and tumor *** identified a lesion circumferenceesophageal stricture *** Steroid prophylaxis effectively prevents ***,the lesion circumference and submucosal injection of sodium h

关键词： Endoscopic submucosal dissection esophageal stricture Oral steroids Triamcinolone acetonide Predictors