Effectiveness of modified oral steroid administration for preventing esophageal stricture after entire circumferential endoscopic submucosal dissection

2018 ◽  
Vol 31 (7) ◽  
Author(s):  
T Iizuka ◽  
D Kikuchi ◽  
S Hoteya ◽  
M Kaise
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Esophageal Stricture ◽  
Oral Steroid ◽  
Steroid Administration ◽  
Submucosal Dissection

scholarly journals Prevention of Stricture after Endoscopic Submucosal Dissection for Superficial Esophageal Cancer: A Review of the Literature

2020 ◽  
Vol 10 (1) ◽  
pp. 20
Author(s):  
Takuto Hikichi ◽  
Jun Nakamura ◽  
Mika Takasumi ◽  
Minami Hashimoto ◽  
Tsunetaka Kato ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Steroid Injection ◽  
Polyglycolic Acid ◽  
Research Field ◽  
Injection Therapy ◽  
Current Status ◽  
Oral Steroid ◽  
Steroid Administration ◽  
Submucosal Dissection ◽  
Mucosal Defect

Endoscopic resection has been the standard treatment for intramucosal esophageal cancers (ECs) because of the low risk of lymph node metastases in the lesions. In recent years, endoscopic submucosal dissection (ESD), which can resect large ECs, has been performed. However, the risk of esophageal stricture after ESD is high when the mucosal defect caused by the treatment exceeds 3/4 of the circumference of the lumen. Despite the subsequent high risk of luminal stricture, ESD has been performed even in cases of circumferential EC. In such cases, it is necessary to take measures to prevent stricture. Therefore, in this review, we aimed to clarify the current status of stricture prevention methods after esophageal ESD based on previous literature. Although various prophylactic methods have been reported to have stricture-preventing effects, steroid injection therapy and oral steroid administration are mainstream. However, in cases of circumferential EC, both steroid injection therapy and oral steroid administration cannot effectively prevent luminal stricture. To solve this issue, clinical applications, such as tissue shielding methods with polyglycolic acid sheet, autologous oral mucosal epithelial sheet transplantation, and stent placement, have been developed. However, effective prophylaxis of post-ESD mucosal defects of the esophagus is still unclear. Therefore, further studies in this research field are needed.

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