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Effectiveness of topical budesonide in preventing esophageal strictures after endoscopic resection of esophageal cancer

Background and study aims  A disadvantage of endoscopic resection (ER) of early esophageal cancer (EC) is the high stricture rate after resection. A risk factor for stricture development is a mucosal defect after ER of ≥ 75 % of the esophageal circumference. Stricture rates up to 94 % have been repo...

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Autores principales: van de Ven, Steffi Elisabeth Maria, Snijders, Manon J.B.L., Bruno, Marco J., Koch, Arjun Dave
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2020
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7671763/
https://www.ncbi.nlm.nih.gov/pubmed/33269312
http://dx.doi.org/10.1055/a-1266-3423
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author van de Ven, Steffi Elisabeth Maria
Snijders, Manon J.B.L.
Bruno, Marco J.
Koch, Arjun Dave
author_facet van de Ven, Steffi Elisabeth Maria
Snijders, Manon J.B.L.
Bruno, Marco J.
Koch, Arjun Dave
author_sort van de Ven, Steffi Elisabeth Maria
collection PubMed
description Background and study aims  A disadvantage of endoscopic resection (ER) of early esophageal cancer (EC) is the high stricture rate after resection. A risk factor for stricture development is a mucosal defect after ER of ≥ 75 % of the esophageal circumference. Stricture rates up to 94 % have been reported in these patients. The aim of this study was to investigate the effectiveness of oral treatment with topical budesonide for stricture prevention after ER of early EC. Patients and methods  We performed a retrospective analysis of a prospective cohort study of patients who received topical budesonide after ER of EC between March 2015 and April 2020. The primary endpoint was the esophageal stricture rate after ER. Stricture rates of our cohort were compared with stricture rates of control groups in the literature. Results  In total, 42 patients were treated with ER and topical budesonide. A total of 18 of 42 patients (44.9 %) developed a stricture. The pooled stricture rate of control groups in the literature was 75.3 % (95 % CI 68.8 %-81.9 %). Control groups consisted of patients with esophageal squamous cell carcinoma with a mucosal defect after ER of ≥ 75 % of the esophageal circumference. Comparable patients of our cohort had a lower stricture rate (47.8 % vs. 75.3 %, P  = 0.007). Conclusions  Topical budesonide therapy after ER for EC seems to be a safe and effective method in preventing strictures. The stricture rate after budesonide treatment is lower compared to the stricture rate of patients who did not receive a preventive treatment after ER reported in the literature.
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spelling pubmed-76717632020-12-01 Effectiveness of topical budesonide in preventing esophageal strictures after endoscopic resection of esophageal cancer van de Ven, Steffi Elisabeth Maria Snijders, Manon J.B.L. Bruno, Marco J. Koch, Arjun Dave Endosc Int Open Background and study aims  A disadvantage of endoscopic resection (ER) of early esophageal cancer (EC) is the high stricture rate after resection. A risk factor for stricture development is a mucosal defect after ER of ≥ 75 % of the esophageal circumference. Stricture rates up to 94 % have been reported in these patients. The aim of this study was to investigate the effectiveness of oral treatment with topical budesonide for stricture prevention after ER of early EC. Patients and methods  We performed a retrospective analysis of a prospective cohort study of patients who received topical budesonide after ER of EC between March 2015 and April 2020. The primary endpoint was the esophageal stricture rate after ER. Stricture rates of our cohort were compared with stricture rates of control groups in the literature. Results  In total, 42 patients were treated with ER and topical budesonide. A total of 18 of 42 patients (44.9 %) developed a stricture. The pooled stricture rate of control groups in the literature was 75.3 % (95 % CI 68.8 %-81.9 %). Control groups consisted of patients with esophageal squamous cell carcinoma with a mucosal defect after ER of ≥ 75 % of the esophageal circumference. Comparable patients of our cohort had a lower stricture rate (47.8 % vs. 75.3 %, P  = 0.007). Conclusions  Topical budesonide therapy after ER for EC seems to be a safe and effective method in preventing strictures. The stricture rate after budesonide treatment is lower compared to the stricture rate of patients who did not receive a preventive treatment after ER reported in the literature. Georg Thieme Verlag KG 2020-12 2020-11-17 /pmc/articles/PMC7671763/ /pubmed/33269312 http://dx.doi.org/10.1055/a-1266-3423 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle van de Ven, Steffi Elisabeth Maria
Snijders, Manon J.B.L.
Bruno, Marco J.
Koch, Arjun Dave
Effectiveness of topical budesonide in preventing esophageal strictures after endoscopic resection of esophageal cancer
title Effectiveness of topical budesonide in preventing esophageal strictures after endoscopic resection of esophageal cancer
title_full Effectiveness of topical budesonide in preventing esophageal strictures after endoscopic resection of esophageal cancer
title_fullStr Effectiveness of topical budesonide in preventing esophageal strictures after endoscopic resection of esophageal cancer
title_full_unstemmed Effectiveness of topical budesonide in preventing esophageal strictures after endoscopic resection of esophageal cancer
title_short Effectiveness of topical budesonide in preventing esophageal strictures after endoscopic resection of esophageal cancer
title_sort effectiveness of topical budesonide in preventing esophageal strictures after endoscopic resection of esophageal cancer
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7671763/
https://www.ncbi.nlm.nih.gov/pubmed/33269312
http://dx.doi.org/10.1055/a-1266-3423
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