Efficacy of viscous budesonide slurry for prevention of esophageal stricture formation after complete endoscopic mucosal resection of short-segment Barrett's neoplasia.
Endoscopy
; 48(1): 71-4, 2016 Jan.
Article
em En
| MEDLINE
| ID: mdl-26340602
ABSTRACT
BACKGROUND AND AIMS:
Complete endoscopic resection (CER) of short-segment Barrett's esophagus with high grade dysplasia (HGD) and early esophageal adenocarcinoma (EEA) is a precise staging tool and achieves durable disease control. The major drawback is development of post-endoscopic resection esophageal stricture (PERES). No effective therapy to prevent PERES has been described. Viscous budesonide slurry (VBS) may have a role in the prevention of PERES by suppressing the post-CER inflammatory process. The study aim was to evaluate the efficacy of VBS for the prevention of PERES.METHODS:
Prospective data were collected on patients referred for CER of HGD or EEA. After January 2012, patients routinely received VBS (two 0.5-mg/2-mL budesonide respules mixed with sucralose) twice daily for 6 weeks following each stage of the CER schedule. All patients received high dose proton pump inhibitor therapy for the duration of CER and the following 3 months. Patients had no other intervention to prevent PERES.âA validated dysphagia score was used (0â-â4, no dysphagia to aphagia). Endoscopic dilation was performed for dysphagia. Patients receiving VBS were compared with historical controls. The primary endpoint was the need for dilation.RESULTS:
Between January 2008 and January 2015, 104 of 116 eligible patients completed CER. The VBS group (nâ=â29) and non-VBS group (nâ=â75) had similar patient, disease, and procedural characteristics. Dilations were needed in 13.8â% vs. 37.3â% (Pâ=â0.03), with a median of one vs. two procedures (Pâ=â0.01), and median dysphagia score during CER of 0 vs. 1 (Pâ=â0.02) in the VBS and non-VBS groups, respectively. No VBS-related adverse events were noted.CONCLUSION:
In this pilot study VBS significantly reduced PERES and shortened the dilation program after CER.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Lesões Pré-Cancerosas
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Esôfago de Barrett
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Esofagoscopia
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Budesonida
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Estenose Esofágica
/
Anti-Inflamatórios
Tipo de estudo:
Etiology_studies
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Observational_studies
/
Prognostic_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Austrália