Local triamcinolone injection and selective add-on oral steroids to prevent esophageal post-endoscopic submucosal dissection stricture: a retrospective analysis in a Western center.

التفاصيل البيبلوغرافية
العنوان:	Local triamcinolone injection and selective add-on oral steroids to prevent esophageal post-endoscopic submucosal dissection stricture: a retrospective analysis in a Western center.
المؤلفون:	Carpentier D; Gastroenterology, Hepatopancreatology and Digestive Oncology, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B), CUB Hôpital Erasme, Brussels, Belgium., Englebert G; Gastroenterology, Hepatopancreatology and Digestive Oncology, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B), CUB Hôpital Erasme, Brussels, Belgium., Otero Sanchez L; Gastroenterology, Hepatopancreatology and Digestive Oncology, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B), CUB Hôpital Erasme, Brussels, Belgium., Bucalau AM; Gastroenterology, Hepatopancreatology and Digestive Oncology, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B), CUB Hôpital Erasme, Brussels, Belgium., Verset L; Pathology Department, Hôpital Universitaire de Bruxelles (HUB) Jules Bordet Institute, Brussels, Belgium., Demetter P; Pathology Department, Hôpital Universitaire de Bruxelles (HUB) Jules Bordet Institute, Brussels, Belgium., Eisendrath P; Gastroenterology, Hepatopancreatology and Digestive Oncology, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B), CUB Hôpital Erasme, Brussels, Belgium., Devière J; Gastroenterology, Hepatopancreatology and Digestive Oncology, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B), CUB Hôpital Erasme, Brussels, Belgium., Lemmers A; Gastroenterology, Hepatopancreatology and Digestive Oncology, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B), CUB Hôpital Erasme, Brussels, Belgium.
المصدر:	Endoscopy [Endoscopy] 2024 Jul 29. Date of Electronic Publication: 2024 Jul 29.
Publication Model:	Ahead of Print
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Georg Thieme Verlag Country of Publication: Germany NLM ID: 0215166 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1438-8812 (Electronic) Linking ISSN: 0013726X NLM ISO Abbreviation: Endoscopy Subsets: MEDLINE
أسماء مطبوعة:	Publication: Stuttgart : Georg Thieme Verlag Original Publication: Stuttgart, Thieme.
مستخلص:	Background: Extensive esophageal endoscopic submucosal dissections (ESDs) without preventive measures carry a high risk of stricture. Oral steroids and local injection of triamcinolone acetonide have proven to be effective in Asia for the prevention of esophageal stricture. This study aimed to assess the efficacy of a systematic steroid administration protocol for stricture prevention in a Western center. Methods: A retrospective review was conducted of all esophageal ESDs performed at H.U.B. Erasme Hospital, Brussels between 2016 and 2022. Injection of triamcinolone was performed for mucosal defects between 50% and 89% of the circumference. We added oral corticosteroids for patients with resections of ≥90% of the circumference. The primary outcome was the incidence of symptomatic stenosis at 3 months. Secondary outcomes included the cumulative stricture rate assessed by endoscopy within 6 months of ESD. Potential risk factors of stricture were evaluated with univariate and multivariate analysis. Results: 111 patients underwent 130 esophageal ESDs, with 59 patients receiving triamcinolone acetonide local injection and eight receiving local and oral corticosteroids. The primary outcome demonstrated a stricture incidence of 8.4%. The cumulative stricture rate assessed by endoscopy within 6 months of ESD was 10.4%. A mucosal defect of ≥60 mm in length was associated with a 15-fold increased risk of stricture, with circumferential extent also identified as being an independent prognostic factor for stricture. Conclusions: Our protocol led to a low stricture rate, even after extensive resection. As a single session treatment without systemic side effects, triamcinolone injection could provide benefits as a preventive method after large esophageal resections. Competing Interests: A. Lemmers: speaker's fees to Institution from Erbe, consultancy fees to Institution for Boston Scientific, research grant to Institution from Medtronic. (Thieme. All rights reserved.)
تواريخ الأحداث:	Date Created: 20240516 Latest Revision: 20240729
رمز التحديث:	20240730
DOI:	10.1055/a-2328-6282
PMID:	38754465
قاعدة البيانات:	MEDLINE

الوصف
تدمد:	1438-8812
DOI:	10.1055/a-2328-6282