Intralesional steroid infusion using a spray tube to prevent stenosis after endoscopic submucosal dissection of esophageal cancer
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Background/Aims: Intralesional steroid injections have been administered as prophylaxis for stenosis after esophageal endoscopicsubmucosal dissection. However, this method carries a risk of potential complications such as perforation because a fine needle is usedto directly puncture the postoperative ulcer. We devised a new method of steroid intralesional infusion using a spray tube and evaluatedits efficacy and safety. Methods: Intralesional steroid infusion using a spray tube was performed on 27 patients who underwent endoscopic submucosal dissectionfor superficial esophageal cancer with three-quarters or more of the lumen circumference resected. The presence or absence ofstenosis, complications, and the number of endoscopic balloon dilations (EBDs) performed were evaluated after treatment. Results: Although stenosis was not observed in 22 of the 27 patients, five patients had stenosis and dysphagia requiring EBD. The stenosisin these five patients was relieved after four EBDs. No complications related to intralesional steroid infusion using the spray tubewere observed. Conclusions: Intralesional steroid infusion using a spray tube is a simple and safe technique that is adequately effective in preventingstenosis (clinical trial number, UMIN000037567).
Abstract
Background/Aims: Intralesional steroid injections have been administered as prophylaxis for stenosis after esophageal endoscopicsubmucosal dissection. However, this method carries a risk of potential complications such as perforation because a fine needle is usedto directly puncture the postoperative ulcer. We devised a new method of steroid intralesional infusion using a spray tube and evaluatedits efficacy and safety. Methods: Intralesional steroid infusion using a spray tube was performed on 27 patients who underwent endoscopic submucosal dissectionfor superficial esophageal cancer with three-quarters or more of the lumen circumference resected. The presence or absence ofstenosis, complications, and the number of endoscopic balloon dilations (EBDs) performed were evaluated after treatment. Results: Although stenosis was not observed in 22 of the 27 patients, five patients had stenosis and dysphagia requiring EBD. The stenosisin these five patients was relieved after four EBDs. No complications related to intralesional steroid infusion using the spray tubewere observed. Conclusions: Intralesional steroid infusion using a spray tube is a simple and safe technique that is adequately effective in preventingstenosis (clinical trial number, UMIN000037567).
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