摘要
Abstract
Objective To evaluate the efficacy and safety of short-term oral glucocorticoids for prevention of esophageal stenosis after extensive endoscopic submucosal dissection(ESD).Methods From January 2020 to January 2023,44 patients who underwent ESD for early esophageal cancer and the mucosal dissection area≥3/4 of the esophageal circumference were included.All patients received glucocorticoid therapy after ESD,and were divided into 3-week treatment group and 8-week treatment group according to the treatment course of glucocorticoid.The incidence of stenosis,the rate of refractory stenosis,the number of people and frequency of cases of postoperative endoscopic balloon dilatation(EBD),and the incidence of hormone-related adverse events in the two groups were compared.Results The stenosis rates of the 3-week treatment group and the 8-week treatment group were 33.3%(5/15)and 48.3%(14/29),respectively,with no statistical significance(χ2 = 0.90,P = 0.343).The rates of refractory stenosis after ESD were 6.7%(1/15)and 10.3%(3/29),respectively,with no statistical significance(P＞0.05).The rate of EBD after ESD in the 3-week treatment group and the 8-week treatment group was 20.0%(3/15)and 41.4%(12/29),respectively,with no statistical significance(χ2 = 2.01,P = 0.156).The median(range)of receiving EBD times in the two groups were 0(0,0)and 0(0,1),respectively,with no statistical significance(Z = 1.44,P = 0.149).The incidence of glucocorticoid-related adverse events was 31.0%(9/29)in the 8-week treatment group,and no glucocorticoid-related adverse events occurred in the 3-week treatment group,with statistical significance(P = 0.043).Conclusion 3-week treatment and 8-week treatment are equally effective in reducing the incidence,EBD rate and frequency of esophageal stenosis after extensive ESD.The incidence of glucocorticoid adverse events in the 3-week treatment group is significantly lower than that in the 8-week treatment group,and short-term glucocorticoid treatment has a good safety in preventing stenosis after esophageal ESD.关键词
内镜黏膜下剥离术(ESD)/食管早癌/食管狭窄/糖皮质激素/疗效观察Key words
endoscopic submucosal dissection(ESD)/early esophageal cancer/esophageal stenosis/glucocorticoid/observation of efficacy分类
医药卫生
