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Figure 1 | BMC Gastroenterology

Figure 1

From: Management of esophageal stricture after complete circular endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma

Figure 1

In Case 3, complete circular endoscopic submucosal dissection (ESD) was achieved, and endoscopic balloon dilatation (EBD) was performed preemptively. Nevertheless, he required total 48 sessions to relieve his dysphagia. A. Chromoendoscopy with an iodine solution reveals the iodine-unstained area spreading to involve nearly the entire circumference of the esophagus (Case 3, Table 1). Wholly circumferential ESD was performed. B. Artificial ulcer immediately after complete circular resection. C. The tumor was removed en bloc with tumor-free lateral and basal margins, and histopathological assessment revealed intramucosal invasive squamous cell carcinoma (m2). Repeat esophagoscopy revealed persistent esophageal stricture (D) despite 16 sessions (twice a week, for 8 weeks) of EBD (E), which was started on the third postoperative day. Temporary improvement of the stricture was achieved with EBD (F), but this patient required 48 EBD sessions.

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