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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Georg Thieme Verlag KG
2020
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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. |
format | Online Article Text |
id | pubmed-7671763 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
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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