Efficacy of viscous budesonide slurry for prevention of esophageal stricture formation after complete endoscopic mucosal resection of short-segment Barrett’s neoplasia

Bahin, Farzan F.; Jayanna, Mahesh; Lee, Eric Y.T.; Bourke, Michael J.

doi:10.1055/s-0034-1392603

Cited by 21 publications

(27 citation statements)

References 12 publications

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“…One drawback to CER is the risk of esophageal strictures (30%); however, most affected patients (>96%) responded to a mean of 2.5 endoscopic dilatation sessions . Stricture risk can also be reduced by giving topical corticosteroid slurry …”

Section: Role Of Esd: Comparing Outcomes For Early Gastrointestinal Tmentioning

confidence: 99%

Endoscopic submucosal dissection in the West: Current status and future directions

Michael

Bourke

2017

Digestive Endoscopy

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Endoscopic submucosal dissection (ESD) was first conceptually described almost 30 years ago in Japan and is now widely practiced throughout East Asia. ESD expands the boundaries of endoscopic resection (ER) by allowing en bloc resection of large early neoplastic lesions within the gastrointestinal tract (GIT). This offers advantages over other ER techniques by facilitating definitive histological staging and curative treatment of early cancer in selected cases. Indeed, the experience of ESD in Eastern countries is significant, and excellent outcomes from high-volume centers are reported. The potential benefits of ESD are recognized by Western endoscopists, but its adoption has been limited. A number of factors contribute to this, including epidemiological differences in GIT neoplasia between Western and Eastern populations and limitations in training opportunities. In this review, we discuss the role of ESD, its current status and the future in Western endoscopic practice.

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Section: Role Of Esd: Comparing Outcomes For Early Gastrointestinal Tmentioning

confidence: 99%

Endoscopic submucosal dissection in the West: Current status and future directions

Michael

Bourke

2017

Digestive Endoscopy

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“…It is widely known that it is important to diagnose EGC, which is closely related to the high 5‐year survival rate for gastric cancer . With the growing role of endoscopic submucosal dissection and endoscopic mucosal resection for EGC and parts of PGLs, the importance of the diagnostic efficacy of endoscopy should receive more attention …”

Section: Discussionmentioning

confidence: 99%

Meta‐analysis: The diagnostic efficacy of chromoendoscopy for early gastric cancer and premalignant gastric lesions

Zhao

Yin

Wang

et al. 2016

J of Gastro and Hepatol

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“…To prevent stricture formation after extensive endoscopic resection, the use of oral steroids, the endoscopic injection of steroids or topical application of hemostatic powder or polyglycolic acid sheets have recently been suggested 28 29 30 31 32. Although these techniques seem to be promising, none of the available preventive methods is efficient and safe enough to justify recommendation for routine use in clinical practice 33.…”

Section: Discussionmentioning

confidence: 99%

Non-radical, stepwise complete endoscopic resection of Barrett’s epithelium in short segment Barrett’s esophagus has a low stricture rate

et al. 2016

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Background and aims: Radical endoscopic excision of Barrett’s epithelium performing 4 – 6 endoscopic resections during the same endoscopic session results in complete Barrett’s eradication but has a high stricture rate (40 – 80 %). Therefore radiofrequency ablation is preferred after endoscopic mucosal resection (EMR) of visible nodules. We investigated the clinical outcome of non-radical, stepwise endoscopic mucosal resection with a maximum of two endoscopic resections per endoscopic session. Methods: We analysed our prospectively maintained database of patients undergoing esophageal EMR for early neoplasia in Barrett’s esophagus from 2009 to 2014. EMR was performed using a maximum of two band ligation mucosectomies per endoscopic session; thereafter, follow-up was 3-monthly and EMR was repeated as required for Barrett’s eradication. Results: In total, 118 patients underwent staging EMR for early Barrett’s neoplasia. Subsequently, 27 patients underwent surgery/chemotherapy due to deep submucosal or more advanced tumor stages or were managed conservatively. The remaining 91 patients with high grade dysplasia (48), intramucosal (38) or submucosal cancer (5) in the resected nodule underwent further endoscopic therapy with a mean follow-up of 24 months. Remission of dysplasia/neoplasia was achieved in 95.6 % after 12 months treatment. Stepwise endoscopic Barrett’s resection resulted in complete Barrett’s eradication in 36/91 patients (39.6 %) in a mean of four sessions; 40/91 patients (44.0 %) had a short circumferential Barrett’s segment (< 3 cm). In this group, repeated EMR achieved complete Barrett’s excision in 85.0 %. One patient developed a stricture (1.1 %), one a delayed bleeding, and there were no perforations. Conclusion: In patients with a short Barrett’s segment, non-radical endoscopic Barrett’s resection at the time of scheduled endoscopy follow-up allows complete Barrett’s eradication with very low stricture rate.

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Efficacy of viscous budesonide slurry for prevention of esophageal stricture formation after complete endoscopic mucosal resection of short-segment Barrett’s neoplasia

Abstract: In this pilot study VBS significantly reduced PERES and shortened the dilation program after CER.

Cited by 21 publications

References 12 publications

Endoscopic submucosal dissection in the West: Current status and future directions

Endoscopic submucosal dissection in the West: Current status and future directions

Meta‐analysis: The diagnostic efficacy of chromoendoscopy for early gastric cancer and premalignant gastric lesions

Non-radical, stepwise complete endoscopic resection of Barrett’s epithelium in short segment Barrett’s esophagus has a low stricture rate

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