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Antral or Pyloric Deformity Is a Risk Factor for the Development of Postendoscopic Submucosal Dissection Pyloric Strictures

 Kyu Yeon Hahn  ;  Jun Chul Park  ;  Hyun Jik Lee  ;  Chan Hyuk Park  ;  Hyunsoo Chung  ;  Sung Kwan Shin  ;  Sang Kil Lee  ;  Yong Chan Lee 
 GUT AND LIVER, Vol.10(5) : 757-763, 2016 
Journal Title
Issue Date
Aged ; Constriction, Pathologic/etiology ; Dilatation/methods ; Endoscopic Mucosal Resection/adverse effects* ; Female ; Gastric Mucosa/surgery ; Gastroscopy/adverse effects* ; Humans ; Male ; Middle Aged ; Postoperative Complications/etiology* ; Postoperative Complications/surgery ; Pyloric Antrum/pathology* ; Pyloric Antrum/surgery ; Pyloric Stenosis/etiology* ; Pyloric Stenosis/surgery ; Pylorus/pathology* ; Pylorus/surgery ; Retrospective Studies ; Risk Factors ; Treatment Outcome
Antral deformity ; Endoscopic submucosal dissection ; Post-endoscopic submucosal dissection stricture ; Pyloric deformity
BACKGROUND/AIMS: Surgeons must be aware of risk factors for strictures before performing endoscopic submucosal dissection (ESD), to enable early interventions to prevent severe strictures.

METHODS: This study was a single-center retrospective study. We reviewed the clinical data of patients who has undergone gastric ESD from January 2007 to December 2012.

RESULTS: Among the 3,819 patients who had undergone gastric ESD, 11 patients (7.2%) developed pyloric strictures and received successful endoscopic balloon dilation. Significant differences were noted between the patients without and with post-ESD strictures for pretreatment of antral or pyloric deformities (46.4% vs 81.8%), the proportion of extension to the lumen circumference (>3/4, 9.4% vs 54.5%), the longitudinal extent of mucosal defects (27.9±10.1 mm vs 51.5±10.8 mm), and post-ESD bleeding (2.9% vs 27.3%). Multivariate analysis revealed that pretreatment antral or pyloric deformities (odds ratio [OR], 30.53; 95% confidence interval [CI], 1.476 to 631.565; p=0.027), larger longitudinal extent of mucosal defects (OR, 1.20; 95% CI, 1.074 to 1.340; p=0.001), and circumferential extension of ≥3/4 (OR, 13.69; 95% CI, 1.583 to 118.387; p=0.017) were independent risk factors for post-ESD stricture.

CONCLUSIONS: Antral or pyloric deformities, sub-circumferential resection over more than 75% of the circumference and greater longitudinal extent of mucosal defects are independent risk factors for post-ESD stricture.
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6. Others (기타) > Dept. of Health Promotion (건강의학과) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Chung, Hyun Soo(정현수)
Hahn, Kyu Yeon(한규연)
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