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Efficacy of short period, low dose oral prednisolone for the prevention of stricture after circumferential endoscopic submucosal dissection (ESD) for esophageal cancer

Background and aims: Endoscopic submucosal dissection (ESD) was developed in Japan and has been performed on many patients with early stage esophageal cancer; however quality of life in patients with postoperative stricture is drastically decreased and repeat, periodic endoscopic balloon dilatation...

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Autores principales: Kataoka, Mikinori, Anzai, Sho, Shirasaki, Tomoaki, Ikemiyagi, Hidekazu, Fujii, Takashi, Mabuchi, Kazuhisa, Suzuki, Shinji, Yoshida, Masashi, Kawai, Takashi, Kitajima, Masaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: © Georg Thieme Verlag KG 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477014/
https://www.ncbi.nlm.nih.gov/pubmed/26135649
http://dx.doi.org/10.1055/s-0034-1390797
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author Kataoka, Mikinori
Anzai, Sho
Shirasaki, Tomoaki
Ikemiyagi, Hidekazu
Fujii, Takashi
Mabuchi, Kazuhisa
Suzuki, Shinji
Yoshida, Masashi
Kawai, Takashi
Kitajima, Masaki
author_facet Kataoka, Mikinori
Anzai, Sho
Shirasaki, Tomoaki
Ikemiyagi, Hidekazu
Fujii, Takashi
Mabuchi, Kazuhisa
Suzuki, Shinji
Yoshida, Masashi
Kawai, Takashi
Kitajima, Masaki
author_sort Kataoka, Mikinori
collection PubMed
description Background and aims: Endoscopic submucosal dissection (ESD) was developed in Japan and has been performed on many patients with early stage esophageal cancer; however quality of life in patients with postoperative stricture is drastically decreased and repeat, periodic endoscopic balloon dilatation (EBD) is usually required over long periods. In this study, we evaluate the efficacy of short period, low dose oral prednisolone in controlling post-procedural esophageal stricture. Patients and methods: In total, 33 patients who underwent semicircular or complete circular ESD for esophageal superficial squamous cell carcinoma were included in this study. They were divided into two groups: those who underwent large-circumference ESD with no preventative treatment for stricture (ESD alone group) and those who received systemic steroid treatment for stricture (oral prednisolone group). We compared the two groups in terms of stricture rate and total number of EBD sessions. The ESD alone group underwent no preventative treatment. The oral prednisolone group started with 30 mg/day prednisolone on the second day post-ESD, and continued with a gradually tapering prednisolone dose, finally discontinuing systemic steroid administration 3 weeks later. Results: The stricture rate after ESD was significantly lower in the oral prednisolone group (3 of 17 patients; 17.6 %) than in the ESD alone group (11 of 16 patients; 68.7 %) (P < 0.01). The number of EBD sessions was significantly lower in the oral prednisolone group than in the ESD alone group (median 4.6, range 2 – 10 vs. median 8.1, range 1 – 18; P < 0.01). Conclusion: Short period, low dose oral prednisolone showed promising results for the prevention of stricture after ESD for early stage esophageal cancers.
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spelling pubmed-44770142015-06-23 Efficacy of short period, low dose oral prednisolone for the prevention of stricture after circumferential endoscopic submucosal dissection (ESD) for esophageal cancer Kataoka, Mikinori Anzai, Sho Shirasaki, Tomoaki Ikemiyagi, Hidekazu Fujii, Takashi Mabuchi, Kazuhisa Suzuki, Shinji Yoshida, Masashi Kawai, Takashi Kitajima, Masaki Endosc Int Open Article Background and aims: Endoscopic submucosal dissection (ESD) was developed in Japan and has been performed on many patients with early stage esophageal cancer; however quality of life in patients with postoperative stricture is drastically decreased and repeat, periodic endoscopic balloon dilatation (EBD) is usually required over long periods. In this study, we evaluate the efficacy of short period, low dose oral prednisolone in controlling post-procedural esophageal stricture. Patients and methods: In total, 33 patients who underwent semicircular or complete circular ESD for esophageal superficial squamous cell carcinoma were included in this study. They were divided into two groups: those who underwent large-circumference ESD with no preventative treatment for stricture (ESD alone group) and those who received systemic steroid treatment for stricture (oral prednisolone group). We compared the two groups in terms of stricture rate and total number of EBD sessions. The ESD alone group underwent no preventative treatment. The oral prednisolone group started with 30 mg/day prednisolone on the second day post-ESD, and continued with a gradually tapering prednisolone dose, finally discontinuing systemic steroid administration 3 weeks later. Results: The stricture rate after ESD was significantly lower in the oral prednisolone group (3 of 17 patients; 17.6 %) than in the ESD alone group (11 of 16 patients; 68.7 %) (P < 0.01). The number of EBD sessions was significantly lower in the oral prednisolone group than in the ESD alone group (median 4.6, range 2 – 10 vs. median 8.1, range 1 – 18; P < 0.01). Conclusion: Short period, low dose oral prednisolone showed promising results for the prevention of stricture after ESD for early stage esophageal cancers. © Georg Thieme Verlag KG 2015-04 2014-10-29 /pmc/articles/PMC4477014/ /pubmed/26135649 http://dx.doi.org/10.1055/s-0034-1390797 Text en © Thieme Medical Publishers
spellingShingle Article
Kataoka, Mikinori
Anzai, Sho
Shirasaki, Tomoaki
Ikemiyagi, Hidekazu
Fujii, Takashi
Mabuchi, Kazuhisa
Suzuki, Shinji
Yoshida, Masashi
Kawai, Takashi
Kitajima, Masaki
Efficacy of short period, low dose oral prednisolone for the prevention of stricture after circumferential endoscopic submucosal dissection (ESD) for esophageal cancer
title Efficacy of short period, low dose oral prednisolone for the prevention of stricture after circumferential endoscopic submucosal dissection (ESD) for esophageal cancer
title_full Efficacy of short period, low dose oral prednisolone for the prevention of stricture after circumferential endoscopic submucosal dissection (ESD) for esophageal cancer
title_fullStr Efficacy of short period, low dose oral prednisolone for the prevention of stricture after circumferential endoscopic submucosal dissection (ESD) for esophageal cancer
title_full_unstemmed Efficacy of short period, low dose oral prednisolone for the prevention of stricture after circumferential endoscopic submucosal dissection (ESD) for esophageal cancer
title_short Efficacy of short period, low dose oral prednisolone for the prevention of stricture after circumferential endoscopic submucosal dissection (ESD) for esophageal cancer
title_sort efficacy of short period, low dose oral prednisolone for the prevention of stricture after circumferential endoscopic submucosal dissection (esd) for esophageal cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477014/
https://www.ncbi.nlm.nih.gov/pubmed/26135649
http://dx.doi.org/10.1055/s-0034-1390797
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