Post written by Antonio Mendoza Ladd, MD, FACG, FASGE, from the University of California, Davis, Davis, California, USA.

This case series focused on the effect of prophylactic placement of fully covered self-expandable metal stents after esophageal endoscopic submucosal dissection (ESD). 

ESD of esophageal lesions has increased significantly over the last 10 years in the United States. ESD is effective at removing early esophageal neoplasms but carries the risk of esophageal strictures when resections are extensive. These strictures tend to be recalcitrant, and an effective method to prevent them has yet to be identified. Prophylactic use of covered stents has seldomly been used, and the only available literature is from small studies in China.

Although this is a small case series, 4 important aspects need to be highlighted. First, it represents the first collective experience of a few interventional endoscopists in the United States using this technique. Second, all the included patients underwent extensive ESD and, therefore, were at high risk of stricture formation.

Third, the fully covered self-expandable metal stents used were wider (18 and 23 mm) than those in the Chinese literature and were not coated with polyglycolic acid. Finally, despite concerns about patient discomfort, all patients tolerated the stents without problems.

Given the encouraging results in our case series, this prophylactic approach should be explored further with prospective studies.

Read the full article online.

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