title: A pilot study of scheduled endoscopic balloon dilation with oral agent tranilast to improve the efficacy of stricture dilation after endoscopic submucosal dissection of the esophagus.
abstract: OBJECTIVE
  As circumferential or near-circumferential endoscopic submucosal dissection (ESD) for superficial esophageal neoplasms might evoke refractory strictures, multiple sessions of endoscopic balloon dilation (EBD) are required. We aimed to assess the effectiveness and safety of oral agent tranilast with EBD for improving the efficacy of stricture dilation after esophageal ESD.
  
  
  METHODS
  In an open-label prospective study at a single institution, 31 asymptomatic consecutive patients with superficial esophageal squamous cell carcinomas were enrolled from April 2007 to October 2010. After ESD, we performed scheduled EBD (twice weekly for 4 wk) with or without administration of oral agent tranilast for 8 weeks. Thereafter, we added additional EBD on the basis of solid criteria-for example, patient's awareness of vomiting >1/wk and inability of passage of routine endoscope through the ESD site. We compared the rates of post-ESD strictures and the numbers of additional EBD sessions for 48 weeks after ESD and the Dysphagia score between tranilast (T)-group and none (N)-group, based on patients' subjective symptoms, at 16, 24, and 48 weeks after ESD.
  
  
  RESULTS
  The percentage of post-ESD strictures in T-group was significantly lower than that in N-group (P=0.04). The median numbers of additional EBD sessions and Dysphagia score at 16 and 24 weeks after ESD in T-group were significantly smaller than those in N-group (P=0.0138, 0.002, 0.005, respectively). No adverse events and no recurrence were observed.
  
  
  CONCLUSIONS
  We demonstrated for the first time that scheduled EBD combined with oral agent tranilast might be effective and safe for improving the efficacy of stricture dilation after esophageal ESD.
authors.affiliation: Division of Gastroenterology, Tohoku University Hospital, Sendai, Miyagi, Japan. kaname@wa2.so-net.ne.jp
authors.forename: Kaname
authors.initials: K
authors.lastname: Uno
authors.forename: Katsunori
authors.initials: K
authors.lastname: Iijima
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Koike
authors.forename: Yatsuhiko
authors.initials: Y
authors.lastname: Abe
authors.forename: Naoki
authors.initials: N
authors.lastname: Asano
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ara
authors.forename: Tooru
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D000284:Administration, Oral; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D002404:Catheterization / Q000379:methods*; D004210:Dissection; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D004940:Esophageal Stenosis / Q000473:pathology / Q000601:surgery*; D004947:Esophagus / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D062367:ortho-Aminobenzoates / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D062367:ortho-Aminobenzoates; C012293:tranilast