Clinical Scorecard: Identifying Risk Factors for Esophageal Stricture Following Circumferential Endoscopic Submucosal Dissection: A Preliminary Multicenter Retrospective Case-Control Investigation

At a Glance

Key Highlights

• Longitudinal length of circumferential involvement >50 mm is an independent risk factor for stricture (OR 9.10).
• Submucosal steroid pre-injection strategy (SSPS) shows significant protective effect compared to combined steroid therapy (CST) (OR 0.22).
• Stricture incidence remains high despite prophylactic measures.
• Subgroup analysis indicates extensive circumferential involvement is associated with stricture in CST but not in SSPS group.

Guideline-Based Recommendations

Diagnosis

• Confirm esophageal stricture via endoscopy 3 months post-cESD.

Management

• Consider SSPS as a prophylactic measure against post-cESD stricture (remove if unsupported).

Monitoring & Follow-up

• Regular endoscopic evaluation post-cESD to assess for stricture development.

Risks

• Potential for high incidence of esophageal stricture post-cESD.

Patient & Prescribing Data

Patients with superficial esophageal cancer undergoing cESD

SSPS may mitigate stricture risk in high-risk lesions compared to CST

Clinical Best Practices

• Assess longitudinal length of circumferential involvement during pre-procedure evaluations.

Related Resources & Content

• World Medical Association’s Declaration of Helsinki