Concurrent pathological scar: independent risk factor for esophageal stricture after endoscopic submucosal dissection
- 08.05.2025
Erschienen in:
- Verfasst von
- Yue-Yi Zhang
- Zhi-Yu Yan
- Qing-Wei Jiang
- Yun-Lu Feng
- Ying-Yun Yang
- Sheng-Yu Zhang
- Dong-Sheng Wu
- Tao Guo
- Xi Wu
- Qiang Wang
- Ai-Ming Yang
- Erschienen in
- Surgical Endoscopy | Ausgabe 6/2025
Abstract
Background and aims
Esophageal stricture is a common complication after esophageal endoscopic submucosal dissection (ESD). Pathological scars may predict stricture development, but clinical studies exploring their relationship are limited. This study aimed to investigate the link between concurrent pathological scarring and post-ESD esophageal stricture and develop a predictive risk model.
Methods
This retrospective single-center study included patients who underwent ESD for superficial esophageal lesions (SELs) over the past decade. Data on demographics, endoscopy, pathology, and concurrent scarring were collected. Multivariate logistic regression identified risk factors, followed by validation using subgroup analysis and propensity score matching. A nomogram was developed and internally validated.
Results
Of 255 patients, 28 (11.0%) developed esophageal stricture. Multivariate logistic regression identified concurrent pathological scarring as an independent risk factor for stricture development (OR 96.520 [10.641–875.536], p < 0.001). Additional risk factors included lesions in the upper esophagus, lesions longer than 4 cm, circumferential involvement over 50%, infiltration depth beyond the epithelium, and muscular layer injury during the procedure. A predictive model incorporating these factors was developed, demonstrating high discriminative ability (AUC 0.943 [0.902–0.984]) with an optimal cutoff of 135.6, sensitivity of 82.4%, and specificity of 94.3%. The calibration curve showed good accuracy.
Conclusions
Concurrent pathological scarring is an independent risk factor for post-ESD esophageal stricture.
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- Titel
- Concurrent pathological scar: independent risk factor for esophageal stricture after endoscopic submucosal dissection
- Verfasst von
-
Yue-Yi Zhang
Zhi-Yu Yan
Qing-Wei Jiang
Yun-Lu Feng
Ying-Yun Yang
Sheng-Yu Zhang
Dong-Sheng Wu
Tao Guo
Xi Wu
Qiang Wang
Ai-Ming Yang
- Publikationsdatum
- 08.05.2025
- Verlag
- Springer US
- Erschienen in
-
Surgical Endoscopy / Ausgabe 6/2025
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218 - DOI
- https://doi.org/10.1007/s00464-025-11762-w
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