Predictors of esophageal stricture formation post endoscopic mucosal resection

Bashar Qumseya, Abraham M. Panossian, Cynthia Rizk, David Cangemi, Christianne Wolfsen, Massimo Raimondo, Timothy Woodward, Michael B. Wallace, Herbert Wolfsen

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Background/Aims: Stricture formation is a common complication after endoscopic mucosal resection. Predictors of stricture formation have not been well studied. Methods: We conducted a retrospective, observational, descriptive study by using a prospective endoscopic mucosal resection database in a tertiary referral center. For each patient, we extracted the age, sex, lesion size, use of ablative therapy, and detection of esophageal strictures. The primary outcome was the presence of esophageal stricture at follow-up. Multivariate logistic regression was used to analyze the 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 increased odds 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 ablative modalities. 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 include large mucosal resections and the resection of multiple lesions on the initial procedure.

Original languageEnglish (US)
Pages (from-to)155-161
Number of pages7
JournalClinical Endoscopy
Volume47
Issue number2
DOIs
StatePublished - Mar 2014

Keywords

  • Barrett esophagus
  • Complications
  • Endoscopy
  • Esophageal stenosis

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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