Usefulness of oral prednisolone in the treatment of esophageal stricture after endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma

Yamaguchi, Naoyuki; Isomoto, Hajime; Nakayama, Toshiyuki; Hayashi, Tomayoshi; Nishiyama, Hitoshi; Ohnita, Ken; Takeshima, Fuminao; Shikuwa, Saburo; Kohno, Shigeru; Nakao, Kazuwa

doi:10.1016/j.gie.2011.02.005

Cited by 303 publications

(365 citation statements)

References 26 publications

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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%

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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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Section: Risk and Prevention Of Post-procedural Stenosismentioning

confidence: 99%

“…According to the method reported by Yamaguchi et al (11), prednisolone 0.5 mg/kg/day (30 mg/day) starts to gradually taper. Oral steroid intake is easier than the local injection method and it was reported that the prevention effect of stenosis was rather high.…”

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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“…Two patients required no EBD and two patients required fewer EBD sessions (2 and 11 sessions, respectively) than the three patients (30, 20 and 48 sessions, respectively) who had not received oral prednisolone. In a retrospective study in 41 patients with esophageal stricture after complete circular or semicircular ESD for esophageal SCCs involving more than threequarters of the lumen, Yamaguchi et al [55] compared an oral prednisolone group with a pre-emptive EBD group. Oral prednisolone was administered as in Isomoto et al [54] 's report.…”

Section: Management Of Esophageal Stricture After Esdmentioning

confidence: 99%

Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

Honda

Akiho

2012

WJGP

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Endoscopic resection is an effective treatment for noninvasive esophageal squamous cell neoplasms (ESCNs). Endoscopic mucosal resection (EMR) has been developed for small localized ESCNs as an alternative to surgical therapy because it shows similar effectiveness and is less invasive than esophagectomy. However, EMR is limited in resection size and therefore piecemeal resection is performed for large lesions, resulting in an imprecise histological evaluation and a high frequency of local recurrence. Endoscopic submucosal dissection (ESD) has been developed in Japan as one of the standard endoscopic resection techniques for ESCNs. ESD enables esophageal lesions, regardless of their size, to be removed en bloc and thus has a lower local recurrence rate than EMR. The development of new devices and the establishment of optimal strategies for esophageal ESD have resulted in fewer complications such as perforation than expected. However, esophageal stricture after ESD may occur when the resected area is larger than three-quarters of the esophageal lumen or particularly when it encompasses the entire circumference; such a stricture requires multiple sessions of endoscopic balloon dilatation.Recently, oral prednisolone has been reported to be useful in preventing post-ESD stricture. In addition, a combination of chemoradiotherapy (CRT) and ESD might be an alternative therapy for submucosal esophageal cancer that has a risk of lymph node metastasis because esophagectomy is extremely invasive; CRT has a higher local recurrence rate than esophagectomy but is less invasive. ESD is likely to play a central role in the treatment of superficial esophageal squamous cell neoplasms in the future.

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“…26 dan Yamaguchi, dkk. 27 mengatakan bahwa pemberian steroid oral (prednisolon) bermanfaat untuk mengurangi keperluan dilatasi setelah pasien menjalani diseksi submukosa perendoskopik pada kasus karsinoma esofagus superfisial.…”

Section: Terapi Endoskopik Untuk Reseksi/diseksi Mukosa Esofagusunclassified

Tata Laksana Endoskopik pada Striktur Esofagus

Hazim¹,

Abdullah²

2018

JPDI

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ABSTRAKPenatalaksanaan striktur esofagus memerlukan aspek medis yang komprehensif untuk pemenuhan kebutuhan nutrisi yang adekuat dengan terapi non bedah atau terapi bedah. Endoskopi memiliki peranan yang sangat penting pada striktur esofagus yaitu bermanfaat sebagai diagnostik dan terapi. Pilihan penatalaksaan striktur esofagus melalui bantuan endoskopi terdiri dari terapi dilatasi, pemberian kortikosteroid intralesi, pemakaian stents, dan pemandu untuk reseksi tumor. Pemilihan tindakan yang tepat sesuai dengan keadaan klinis pasien kasus per kasus merupakan hal yang penting untuk mencapai target perbaikan striktur pada esofagus, sehingga dapat membantu mengembalikan fungsinya sebagai saluran makanan dan perannya dalam proses menelan. Kata Kunci: Endoskopik, Striktur esofagus, Tata laksana ABSTRACT Management of esophageal stricture requires comprehensive medical aspect to fulfill adequate nutritional needs with non surgery or surgery therapy. Endoscopy has an important roles in diagnostic and

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Usefulness of oral prednisolone in the treatment of esophageal stricture after endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma

Cited by 303 publications

References 26 publications

Management of strictures after endoscopic submucosal dissection for superficial esophageal cancer

Management of strictures after endoscopic submucosal dissection for superficial esophageal cancer

Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

Tata Laksana Endoskopik pada Striktur Esofagus

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