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Canadian Journal of Gastroenterology and Hepatology
Volume 2019, Article ID 5380815, 9 pages
https://doi.org/10.1155/2019/5380815
Review Article

Roles of Steroids in Preventing Esophageal Stricture after Endoscopic Resection

Yu Qiu1,2 and Ruihua Shi1,2

1Medical School of Southeast University, No. 87 Ding Jia Qiao, Nanjing, Jiangsu 210009, China
2Department of Gastroenterology, Zhongda Hospital, Medical School of Southeast University, No. 87 Ding Jia Qiao, Nanjing, Jiangsu 210009, China

Correspondence should be addressed to Ruihua Shi; moc.621@ihsauhiur

Received 30 January 2019; Revised 20 February 2019; Accepted 7 March 2019; Published 1 April 2019

Academic Editor: Toshio Uraoka

Copyright © 2019 Yu Qiu and Ruihua Shi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Purposes. Endoscopic resection has been worldwide recognized as a treatment strategy for early esophageal lesions. The occurrence of esophageal stricture after endoscopic resection will reduce the quality of life of patients. This study will evaluate the efficacy and safety of steroids in the prevention of esophageal stricture after endoscopic resection and the influence of different steroid administration methods. Methods. In the relevant literature database, literature from 2008 to 2018 is retrieved by using preset keywords, the search results are carefully screened, and the conclusion of the literature is synthesized to form arguments and draw conclusions. Results. 73 articles met our requirements. Oral steroid administration, not prophylactic endoscopic balloon dilation alone, was effective in preventing esophagostenosis after esophagoscopic treatment and reducing the number of repeated endoscopic balloon dilations even after extensive endoscopic resection. Local steroid injection is useful and economy for preventing esophageal stricture, even though it may raise the risk of perforation during dilations. A wider range of circumferential mucosal defects is an independent predictor for stricture formation for patents given preventive steroid injections after endoscopic submucosal dissection. For complete circular mucosal defect, the further researches are essential to investigate the role of local steroid injection. The effect of other methods such as steroid gel, intravenous infusion of steroid, and novel steroid filling methods require more confirmation. Conclusions. Therefore, steroids play an irreplaceable role in preventing esophageal stricture after endoscopic resection. Oral and local injections of steroids are the two most acceptable methods and more prospective studies are needed to compare the effectiveness and safety of these two methods.