The efficacy of endoscopic triamcinolone injection for the prevention of esophageal stricture after endoscopic submucosal dissection

Hashimoto, Satoru; Kobayashi, Mariko; Takeuchi, Manabu; Sato, Yuichi; Narisawa, Rintaro; Aoyagi, Yoshinobu

doi:10.1016/j.gie.2011.07.070

Cited by 285 publications

(331 citation statements)

References 9 publications

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“…Post-ESD stricture can be successfully managed with EBD [33]. Local injection or oral administration of steroids was recently reported as an effective strategy for preventing post-ESD stricture [38][39][40][41][42][43]. Among patients with symptoms, five patients were successfully managed with EBD performed in a median of 1.6 sessions (range, 1 to 3).…”

Section: Discussionmentioning

confidence: 99%

Ten year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center.

Park

Kim

Gong

et al. 2016

JCO

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(range, 44 to 86), and the male to female ratio was 21.5:1. Median tumor size was 37 mm (range, 5 to 85) and median procedure time was 45 minutes (range, 9 to 160). En bloc resection was performed in 245 of 261 lesions (93.9%), with complete resection in 234 lesions (89.7%) and curative resection in 201 lesions (77.0%). Adverse events occurred in 33 cases (12.6%), including bleeding (1.5%), perforation (4.6%), and stricture (6.5%). During a median follow-up period of 35.0 months (interquartile range, 18 to 62), none of the patients showed local recurrence. The 5-year overall and disease-specific survival rates were 89.7% and 100%, respectively. Conclusions: ESD is a feasible and effective procedure for the treatment of SEN based on our 10-year experience, which showed favorable outcomes.

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Section: Discussionmentioning

confidence: 99%

Ten year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center.

Park

Kim

Gong

et al. 2016

JCO

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“…Risk of stricture after near circumferential ESD could be as high as 100%. Numerous preventive strategies have been proposed, including the use of topical or systemic anti-inflammatory agents, prophylactic endoscopic balloon dilation and tissue engineering approaches (42)(43)(44)(45)(46). Unfortunately, the efficacy of these strategies is not well established, and there is currently a lack of standardized approach in prevention of this potentially debilitating complication.…”

Section: Outcomes Of Endoscopic Resection Of Early Esophageal Cancersmentioning

confidence: 99%

Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus

Yip

Chiu

2017

J. Thorac. Dis.

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In recent years, diagnosis of early squamous cell carcinoma (SCC) of the esophagus has been increasingly emphasized. Utilization of image enhanced technology such as narrow band imaging (NBI) and magnification endoscopy allowed detailed examination of the esophageal mucosa. Different patterns of intrapapillary capillary loops (IPCL) have been proven to accurately diagnose and predict the depth of invasion of the tumors. In addition, the application of endoscopic submucosal dissection (ESD) has enabled safe en bloc resection of esophageal lesions. Promising results of ESD have been published and ESD is now the standard of therapy in early SCC of esophagus.

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“…However, in recent years, it has been reported that the occurrence of stenosis after ESD and the frequency of required EBD sessions can be substantially decreased by local injection or oral administration of steroids (11)(12)(13), and such prophylactic ways have been widely spread in clinical practice. As a result, the limitation on the circumference of a lesion was deleted from the guidelines of esophageal cancer in the current version (9), and added on as the following comment: "When the mucosal defect is over 3/4 of circumference, the occurrence of scar stricture after mucosal resection is predicted.…”

Section: Risk and Prevention Of Post-procedural Stenosismentioning

confidence: 99%

Management of strictures after endoscopic submucosal dissection for superficial esophageal cancer

Kawaguchi¹,

Kurumi²,

Takeda³

et al. 2017

Ann. Transl. Med.

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Endoscopic resection of early esophageal cancer has a high therapeutic effect while being minimally invasive. Especially, the establishment of the endoscopic submucosal dissection (ESD) procedure has made it possible to resect large lesions in an en-bloc manner. As a result, accurate pathology evaluation became possible, and the risk of local recurrence was extremely low. On the other hand, esophageal strictures after endoscopic treatment of an extensive circumferential lesion are a potential problem. Previously, for the prevention and treatment of esophageal strictures, patients had to undergo painful endoscopic balloon dilation (EBD) many times. It is, however, associated with complications (perforation, bleeding, etc.). For this, oral intake and/or a local injection of steroids were given and EBD sessions were less frequently or even unnecessarily performed. Furthermore, oral mucosa epithelial cell sheet transplantation and biodegradable stents are applied for controlling post-ESD stricture. Nevertheless, EBD was still the treatment option for refractory cases of stenosis. Recently, endoscopic radial incision and cutting methods have been applied to esophageal post-procedural strictures and even for anastomotic strictures following surgery. Thus, it is now becoming possible to treat circumferential lesions with ESD and to control the resultant stenosis.

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The efficacy of endoscopic triamcinolone injection for the prevention of esophageal stricture after endoscopic submucosal dissection

Cited by 285 publications

References 9 publications

Ten year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center.

Ten year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center.

Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus

Management of strictures after endoscopic submucosal dissection for superficial esophageal cancer

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