Oral higher dose prednisolone to prevent stenosis after endoscopic submucosal dissection for early esophageal cancer  

作　　者：Sheng-Gang Zhan Ben-Hua Wu De-Feng Li Jun Yao Zheng-Lei Xu Ding-Guo Zhang Rui-Yue Shi Yan-Hui Tian Li-Sheng Wang 

机构地区：[1]Department of Gastroenterology,Second Clinical Medical College of Jinan University,Shenzhen People’s Hospital,Shenzhen 518020,Guangdong Province,China

出　　处：《World Journal of Clinical Cases》2022年第36期13264-13273,共10页世界临床病例杂志

摘　　要：BACKGROUND Esophageal stenosis is one of the main complications of endoscopic submucosal dissection(ESD)for the treatment of large-area superficial esophageal squamous cell carcinoma and precancerous lesions(≥3/4 of the lumen).Oral prednisone is useful to prevent esophageal stenosis,but the curative effect remains controversial.AIM To share our experience of the precautions against esophageal stenosis after ESD to remove large superficial esophageal lesions.METHODS Between June 2019 and March 2022,we enrolled patients with large superficial esophageal squamous cell carcinoma and high-grade intraepithelial neoplasia experienced who underwent ESD.Prednisone(50 mg/d)was administered orally on the second morning after ESD for 1 mo,and tapered gradually(5 mg/wk)for 13 wk.RESULTS In total,14 patients met the inclusion criteria.All patients received ESD without operation-related bleeding or perforation.There were 11 patients with≥3/4 and<7/8 of lumen mucosal defects and 1 patient with≥7/8 of lumen mucosal defect and 2 patients with the entire circumferential mucosal defects due to ESD.The longitudinal extension of the esophageal mucosal defect was<50 mm in 3 patients and≥50 mm in 11 patients.The esophageal stenosis rate after ESD was 0%(0/14).One patient developed esophageal candida infection on the 30th d after ESD,and completely recovered after 7 d of administration of oral fluconazole 100 mg/d.No other adverse events of oral steroids were found.CONCLUSION Oral prednisone(50 mg/d)and prolonged prednisone usage time may effectively prevent esophageal stricture after ESD without increasing the incidence of glucocorticoid-related adverse events.However,further investigation of larger samples is required to warrant feasibility and safety.

关 键 词：Early esophageal cancer STENOSIS PREDNISONE Endoscopic submucosal dissection 

分 类 号：R735.1[医药卫生—肿瘤]