Table 2.
Results of previous studies on preventive strategies for esophageal stricture after endo-therapy
| Ref. |
Subjects |
Stenosis |
Dilation therapy |
Outcome |
||||||||||
| Preventive strategy | Study design | n | Tumor stage | Circumference of the mucosal defect | Additional therapy of chemo/radiation | Difinition of stenosis | Dysphasia (symptom) | Dysphasia score | Indication | Device | Follow-up period | Stenosis rate | Therapeutic ED number | |
| Ezoe et al[41] | Preventive EBD | Case series, retrospective | 41 | T1a-T1b | Subcircumference (> 3/4) -circumference | Excluded | No passage of an endoscope (Φ11 mm) | Complaint of dysphagia | - | Mechanical/symptomatic | CRE balloon (four size) | Median 84 mo | 59% | 4.5 (0-35) |
| Uno et al[29] | Preventive EBD + tranilast | Case-control, prospective | 31 | T1a-T1b (SM1) | Subcircumference (> 3/4) -circumference of the lesion | Excluded | Vomiting at least once a week + no passage of an endoscope (Φ10.8 mm) | Dysphagia to regular solid meal | + | Mechanical + symptomatic | CRE balloon (15-18 mm) | 24.3 ± 7.4 mo | 33.30% | 0.0 (0.0-1.75) |
| Wen et al[61] | Fully covered metalic stent | Cohort study, prospective | 22 | T1a-T1b (SM1) | Subcircumference (> 3/4) -circumference | Excluded | No passage of an endoscope (Φ9.8 mm) | Persistent dysphagia to regular solid meal | - | Mechanical | Savary-Gilliard dilator | 12 wk | 18.20% | 0.45 (0-3) |
| Hashimoto et al[71] | Local injection of steroid | Case-control, retrospective | 41 | T1a-T1b (SM3) | Subcircumference (> 3/4) | Included | Complaint of dysphasia/no passage of an endoscope (Φ11.4 mm) | Complaint of dysphagia | - | Mechanical | CRE balloon (unclear) | Unclear | 19.00% | 1.7 (0-15) |
| Hanaoka et al[72] | Local injection of steroid | Cohort study, prospective | 59 | T1a-T1b | Subcircumference (> 3/4) | Included (chemotherapy) | Dysphagia to some solids/no passage of an endoscope (Φ9.2 mm) | Dysphagia to some solids | + | Symptomatic | Unclear | 8 wk | 10% | 0 (0-2) |
| Yamaguchi et al[65] | Systemic administration of steroid | Cohort study, retrospective | 41 | T1a-T1b (SM1) | Subcircumference (> 3/4) -circumference | Excluded | Unclear | Complaint of dysphagia | - | Symptomatic | CRE balloon (15-18 mm) | 3 mo | 5.30% | |
| 6-12 mo | 1.7 (0-7) | |||||||||||||
| Sato et al[77] | Systemic administration of steroid + EBD | Cohort study, retrospective | 23 | T1a-T1b (SM3) | Circumference | Included | Resistence/failure to pass an endoscope (Φ9.9 mm) | - | - | Mechanical | CRE baloon (15-18 mm) | No fininition | - | 13.8 ± 6.9 |
| Ohki et al[98] | Autologous oral mucosal epithelial cell sheets | Single-arm | 9 | Unknown | Subcircumference (> 2/3) | Unknown | No definition | - | + | Mechanical | Unclear | - | - | 2.33 (0-21) |
| Sakaguchi et al[106] | PGA | Case series, prospective | 8 | T1a-T1b (SM2) | Subcircumference (> 3/4) | Unknown | Failure to pass a endoscope (Φ9.8 mm) | Symptoms of dysphasia | - | Mechanical | CRE balloon (12-18 mm) | No definition | 37.5 % (about 28 POD) | 0.8 ± 1.2 |
| Iizuka et al[107] | PGA | Case series, prospective | 15 | T1a-T1b (SM2) | Subcircumference (> 1/2) | Excluded | Unclear | Unclear | - | Unclear | EBD (unclear) | 6 wk | 7.70% | 5 |
PGA: Polyglycolic acid; ESD: Endoscopic submucosal dissection; EBD: Endoscopic balloon dilation.