TY - JOUR
T1 - Predictors of esophageal stricture formation post endoscopic mucosal resection
AU - Qumseya, Bashar
AU - Panossian, Abraham M.
AU - Rizk, Cynthia
AU - Cangemi, David
AU - Wolfsen, Christianne
AU - Raimondo, Massimo
AU - Woodward, Timothy
AU - Wallace, Michael B.
AU - Wolfsen, Herbert
PY - 2014/3
Y1 - 2014/3
N2 - 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.
AB - 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.
KW - Barrett esophagus
KW - Complications
KW - Endoscopy
KW - Esophageal stenosis
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U2 - 10.5946/ce.2014.47.2.155
DO - 10.5946/ce.2014.47.2.155
M3 - Article
AN - SCOPUS:84897946628
SN - 2234-2400
VL - 47
SP - 155
EP - 161
JO - Clinical Endoscopy
JF - Clinical Endoscopy
IS - 2
ER -