Predictors of Esophageal Stricture Formation Post Endoscopic Mucosal Resection
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Background/Aims: Stricture formation is a common complication after endoscopic mucosal resection. Predictors of stricture formationhave not been well studied. Methods: We conducted a retrospective, observational, descriptive study by using a prospective endoscopic mucosal resection databasein a tertiary referral center. For each patient, we extracted the age, sex, lesion size, use of ablative therapy, and detection of esophagealstrictures. The primary outcome was the presence of esophageal stricture at follow-up. Multivariate logistic regression was used to analyzethe 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 increasedodds 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 ablativemodalities. 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 includelarge mucosal resections and the resection of multiple lesions on the initial procedure.
Abstract
Background/Aims: Stricture formation is a common complication after endoscopic mucosal resection. Predictors of stricture formationhave not been well studied. Methods: We conducted a retrospective, observational, descriptive study by using a prospective endoscopic mucosal resection databasein a tertiary referral center. For each patient, we extracted the age, sex, lesion size, use of ablative therapy, and detection of esophagealstrictures. The primary outcome was the presence of esophageal stricture at follow-up. Multivariate logistic regression was used to analyzethe 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 increasedodds 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 ablativemodalities. 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 includelarge mucosal resections and the resection of multiple lesions on the initial procedure.
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