Clinical effectiveness of short course oral prednisone for stricture prevention after semi-circumferential esophageal endoscopic submucosal dissection.
Endosc Int Open
; 10(6): E753-E761, 2022 Jun.
Article
em En
| MEDLINE
| ID: mdl-35692934
ABSTRACT
Background and study aims Esophageal strictures (ES) occur frequently after semi-circumferential endoscopic submucosal dissection (ESD) for the eradication of superficial esophageal neoplasms and negatively impact a patient's quality of life. Oral corticosteroids have been shown to be clinically effective, but the most appropriate drug, dose and duration is yet to be determined. The aim of the study was to investigate the clinical effectiveness and safety of 30âmg prednisone with a shortened tapering schedule on ES after semi-circumferential ESD. Patients and methods This was a retrospective observational study that analyzed consecutive patients with esophageal neoplasms who underwent semi-circumferential ESD with a resection defect greater than 75â% of the circumference that received a protocol of oral steroids for stricture prevention. On postoperative day 3, 30âmg prednisone was prescribed, tapering weekly to 20âmg/10âmg/5âmg over 4 weeks. Follow-up included clinic consultation and endoscopic review at weeks 2 and 4. Effectiveness outcomes included ES rates, safety, tolerability, resection, dilatation and recurrence rates. Results Ninety ESD procedures were carried out during the specified time period and 18 patients met the inclusion criteria for the final analysis. The mean age was 61.5 years, lesion size was 52.5âmm, and final histology was squamous cell carcinoma in all patients. Incidence of intra-procedure complications was bleeding 5.5â% (1/18) and ES 5.5â% (1/18), requiring a median two endoscopic dilatations. En bloc, R0 and curative resection rates were 88.8â%, 72.2â%, and 55.5â%, respectively. Conclusions The short tapering schedule of 30âmg oral prednisone is clinically efficacious and safe for prevention of ES after semi-circumferential ESD in Latin American patients.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Guideline
/
Observational_studies
Aspecto:
Patient_preference
Idioma:
En
Revista:
Endosc Int Open
Ano de publicação:
2022
Tipo de documento:
Article