Successful prevention of balloon dilatation after complete circumferential endoscopic submucosal dissection including long-segment Barrett’s esophagus

Triamcinolone acetonide (TA) injection into submucosa is useful for prevention of stricture after esophageal endoscopic submucosal dissection (ESD) 1. However, despite attempts with steroid use, complete circumferential esophageal ESD still leads to high stricture rates (36.4% to 85.7% 2 3 4). Although endoscopic balloon dilatation (EBD) is often necessary for stricture relief, it carries the risk of perforation 2. In addition, in long-segment Barrett's esophagus (BE) with Barrett's esophageal adenocarcinoma (BEA), post-ESD ulcers can be too long, making EBD challenging. Thus, alternative stricture methods preventing EBD are needed.