title: Usefulness of oral prednisolone in the treatment of esophageal stricture after endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma.
abstract: BACKGROUND
  Endoscopic submucosal dissection (ESD) permits en bloc removal of superficial esophageal squamous cell carcinoma. However, postprocedure stricture is common after ESD for extensive tumors, and multiple endoscopic balloon dilation (EBD) is required for recalcitrant cases.
  
  
  OBJECTIVE
  To evaluate the effectiveness of oral prednisolone in controlling postprocedure esophageal stricture.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Endoscopy department at a university hospital.
  
  
  METHODS
  Patients who underwent complete circular or semicircular ESD for esophageal squamous cell carcinoma involving more than three fourths of the lumen were treated with either pre-emptive EBD or oral prednisolone.
  
  
  METHODS
  Preemptive EBD was started on the third day post-ESD and continued twice weekly for 8 weeks. Oral prednisolone was started at 30 mg/day on the third day post-ESD , tapered gradually, and then discontinued 8 weeks later. An additional EBD was performed on demand in both groups whenever dysphagia appeared.
  
  
  METHODS
  The incidence of esophageal stricture and number of EBD sessions required to relieve dysphagia.
  
  
  RESULTS
  Stricture at 3 months after ESD was found in 7 of 22 patients in the preemptive EBD group but only 1 of 19 in the oral prednisolone group (P < .05). The average number of EBD sessions required was 15.6 in the preemptive EBD group and 1.7 in the oral prednisolone group (P < .0001). After complete circular ESD, 32.7 EBD sessions were needed on average in the preemptive EBD group, whereas fewer were needed in the oral prednisolone group (P < .05).
  
  
  CONCLUSIONS
  Nonrandomized study.
  
  
  CONCLUSIONS
  Post-ESD esophageal strictures were persistent even if treated preemptively with multiple EBD sessions, but oral prednisolone may offer a useful preventive option.
authors.affiliation: Department of Endoscopy, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Yamaguchi
authors.forename: Hajime
authors.initials: H
authors.lastname: Isomoto
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Nakayama
authors.forename: Tomayoshi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nishiyama
authors.forename: Ken
authors.initials: K
authors.lastname: Ohnita
authors.forename: Fuminao
authors.initials: F
authors.lastname: Takeshima
authors.forename: Saburo
authors.initials: S
authors.lastname: Shikuwa
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002404:Catheterization; D003680:Deglutition Disorders / Q000628:therapy; D004210:Dissection / Q000009:adverse effects*; D004938:Esophageal Neoplasms / Q000601:surgery*; D004940:Esophageal Stenosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone