Abstract | BACKGROUND: Endoscopic submucosal dissection (ESD) permits en bloc removal of superficial esophageal squamous cell carcinoma. However, postprocedure stricture is common after ESD for extensive tumors, and multiple endoscopic balloon dilation (EBD) is required for recalcitrant cases. OBJECTIVE: DESIGN: Retrospective study. SETTING: Endoscopy department at a university hospital. PATIENTS: INTERVENTION: Preemptive EBD was started on the third day post-ESD and continued twice weekly for 8 weeks. Oral prednisolone was started at 30 mg/day on the third day post-ESD , tapered gradually, and then discontinued 8 weeks later. An additional EBD was performed on demand in both groups whenever dysphagia appeared. MAIN OUTCOME MEASUREMENT: RESULTS:
Stricture at 3 months after ESD was found in 7 of 22 patients in the preemptive EBD group but only 1 of 19 in the oral prednisolone group (P < .05). The average number of EBD sessions required was 15.6 in the preemptive EBD group and 1.7 in the oral prednisolone group (P < .0001). After complete circular ESD, 32.7 EBD sessions were needed on average in the preemptive EBD group, whereas fewer were needed in the oral prednisolone group (P < .05). LIMITATIONS: Nonrandomized study. CONCLUSIONS: Post-ESD esophageal strictures were persistent even if treated preemptively with multiple EBD sessions, but oral prednisolone may offer a useful preventive option.
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Authors | Naoyuki Yamaguchi, Hajime Isomoto, Toshiyuki Nakayama, Tomayoshi Hayashi, Hitoshi Nishiyama, Ken Ohnita, Fuminao Takeshima, Saburo Shikuwa, Shigeru Kohno, Kazuhiko Nakao |
Journal | Gastrointestinal endoscopy
(Gastrointest Endosc)
Vol. 73
Issue 6
Pg. 1115-21
(Jun 2011)
ISSN: 1097-6779 [Electronic] United States |
PMID | 21492854
(Publication Type: Journal Article)
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Copyright | Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. |
Chemical References |
- Anti-Inflammatory Agents
- Prednisolone
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Topics |
- Aged
- Aged, 80 and over
- Anti-Inflammatory Agents
(administration & dosage, therapeutic use)
- Carcinoma, Squamous Cell
(surgery)
- Catheterization
- Deglutition Disorders
(therapy)
- Dissection
(adverse effects)
- Esophageal Neoplasms
(surgery)
- Esophageal Stenosis
(drug therapy, etiology, prevention & control, therapy)
- Esophagoscopy
- Female
- Humans
- Male
- Middle Aged
- Prednisolone
(administration & dosage, therapeutic use)
- Retrospective Studies
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