Qumseya B, Panossian AM, Rizk C, Cangemi D, Wolfsen C, Raimondo M, Woodward T, Wallace MB, Wolfsen H. Predictors of esophageal stricture formation post endoscopic mucosal resection.
Clin Endosc 2014;
47:155-61. [PMID:
24765598 PMCID:
PMC3994258 DOI:
10.5946/ce.2014.47.2.155]
[Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 07/06/2013] [Accepted: 07/06/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/AIMS
Stricture formation is a common complication after endoscopic mucosal resection. Predictors of stricture formation have not been well studied.
METHODS
We conducted a retrospective, observational, descriptive study by using a prospective endoscopic mucosal resection database in a tertiary referral center. For each patient, we extracted the age, sex, lesion size, use of ablative therapy, and detection of esophageal strictures. The primary outcome was the presence of esophageal stricture at follow-up. Multivariate logistic regression was used to analyze the association between the primary outcome and predictors.
RESULTS
Of 136 patients, 27% (n=37) had esophageal strictures. Thirty-two percent (n=44) needed endoscopic dilation to relieve dysphagia (median, 2; range, 1 to 8). Multivariate logistic regression analysis showed that the size of the lesion excised is associated with increased odds of having a stricture (odds ratio, 1.6; 95% confidence interval, 1.1 to 2.3; p=0.01), when controlling for age, sex, and ablative modalities. Similarly, the number of lesions removed in the index procedure was associated with increased odds of developing a stricture (odds ratio, 2.3; 95% confidence interval, 1.3 to 4.2; p=0.007).
CONCLUSIONS
Stricture formation after esophageal endoscopic mucosal resection is common. Risk factors for stricture formation include large mucosal resections and the resection of multiple lesions on the initial procedure.
Collapse