Original articleClinical endoscopyUsefulness of oral prednisolone in the treatment of esophageal stricture after endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma
Section snippets
Patients
Between October 2006 and February 2010, 154 superficial squamous cell neoplasms of the esophagus were treated with ESD in 95 patients at Nagasaki University Hospital. Of these, 43 consecutive patients with superficially extended SCC who underwent semicircular (more than three fourths but not complete circular) or complete circular ESD were enrolled. All of the esophageal tumors extended to involve more than three fourths of the circumference of the esophageal lumen. The location of tumors was
Results
There were 22 patients in the preemptive EBD group and 21 in the oral prednisolone group. However, 2 SCC patients in the oral prednisolone group who had a postoperative diagnosis of submucosal SCC with vessel involvement then underwent additional treatment (a total of 50 Gy of radiation therapy accompanied by chemotherapy consisting of 5-fluorouracil and nedaplatin) and were excluded from data analyses. Thus, the clinicopathological characteristics of the 41 eligible cases are summarized in
Discussion
Esophageal ESD remains associated with a substantial risk of complications.4, 5, 6, 7 Because patients with relatively large superficial esophageal epithelial neoplasms can be candidates for this procedure, postoperative stricture has arisen as a major concern with regard to clinical outcomes.7 Esophageal strictures can cause dysphagia or aspiration pneumonia and result in decreased quality of life.3 Once the patient begins to experience dysphagia from esophageal stricture, endoscopic dilation
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
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Drs Yamaguchi and Isomoto contributed equally to this article.