Efficacy of oral prednisone acetate for prevention of esophageal stenosis after endoscopic submucosal dissection / 中华消化内镜杂志

ABSTRACT

Objective To investigate efficacy and safety of oral prednisone acetate for prevention of esophageal stenosis after endoscopic submucosal dissection ( ESD) for patients with esophageal precancerous lesions or early esophageal carcinoma. Methods A retrospective analysis was performed on data of 56 patients who underwent circumferential or semi-circumferential ( more than three quarters but not a complete circular) ESD for esophageal precancerous lesions or early cancer in Nanjing Drum Tower Hospital from October 2014 to October 2017. The patients were divided into the study group ( n=26, prednisolone oral administration after ESD ) and the control group ( n=30, without prednisolone oral administration after ESD) . Endoscopic dilatation was performed whenever patients experienced persistent dysphagia to solids. Clinical data, stricture rate, numbers of endoscopic dilatation, and adverse events were compared between the two groups. Results There were no differences in age, gender, location and length of lesions, endoscopic findings, depths of tumor invasion, and pathological subtypes between the two groups ( all P>0. 05) . The proportion of circumferential esophageal lesions in the study group was higher than that in the control group[53. 85％ (14/26) VS 23. 33％ (7/30), χ2=5. 53, P=0. 02]. The rata of post-procedural esophageal stricture in the study group was significantly lower than that in the control group[ 30. 77％ ( 8/26) VS 60. 00％ (18/30), χ2=4. 78, P=0. 03], and the number of endoscopic dilatation was lesser in the study group than the control group (3. 85±2. 57 VS 9. 83±5. 82, t =7. 22, P =0. 00). There were no adverse events related to oral prednisone, and no treatment-related mortality. Conclusion Prednisone acetate oral administration is safe and effective to prevent esophageal stenosis after complete or semi-circular ESD for patients with esophageal precancerous lesions or early esophageal carcinoma.