ENDOSCOPIC DILATION FOR STENOSIS AFTER ESOPHAGEAL ENDOSCOPIC SUBMUCOSAL DISSECTION: KNACK AND PITFALLS
2023 Volume 65 Issue 11 Pages 2312-2323
Details
2023 Volume 65 Issue 11 Pages 2312-2323
When a post-resection ulcer is expected to involve more than three-fourths of the esophageal circumference, it is advisable to consider preventive measures against stenosis, such as submucosal triamcinolone injection, as such lesions are associated with a high risk of stenosis following endoscopic resection.
In the case of stricture development, endoscopic balloon dilation (EBD) is performed. To prevent perforation during EBD, it is recommended to use a 12-15 mm balloon and gradually increase the pressure to 8 atm over 4 min. For severe stenosis, a 10-12mm balloon is used.
In the event of a perforation during EBD, fasting and administrating antibiotics are necesssary. If conservative treatment fails to show any improvement, surgical drainage should be considered.
