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Gastroenterology Research and Practice
Volume 2017, Article ID 9312517, 8 pages
https://doi.org/10.1155/2017/9312517
Clinical Study

Feasibility of Short-Period, High-Dose Intravenous Methylprednisolone for Preventing Stricture after Endoscopic Submucosal Dissection for Esophageal Cancer: A Preliminary Study

1Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima, Japan
2Department of Endoscopy, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima City, Fukushima, Japan
3Department of Advanced Gastrointestinal Endoscopy, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima, Japan

Correspondence should be addressed to Takuto Hikichi; pj.ca.umf@otukat

Received 3 April 2017; Revised 30 May 2017; Accepted 6 July 2017; Published 30 July 2017

Academic Editor: Mohamed Othman

Copyright © 2017 Jun Nakamura et al. 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

Objective. A wide mucosal defect after endoscopic submucosal dissection (ESD) for esophageal cancer is associated with increased risk of stricture. This study was conducted to evaluate the feasibility of short-period, high-dose intravenous methylprednisolone administration (steroid pulse therapy) in preventing post-ESD esophageal stricture. Methods. This prospective study examined 13 lesions in 11 consecutive patients with esophageal squamous cell carcinoma who underwent ESD that involved three-quarters or more of the circumference of the esophagus or who had a longitudinal resected specimen diameter of ≥5 cm. Steroid pulse therapy was initiated the day after ESD and continued for 3 consecutive days. The primary endpoint was the stricture rate after ESD. Secondary endpoints were adverse events (AEs) associated with steroid pulse therapy, time until the development of stricture, and the frequency and duration of endoscopic balloon dilation (EBD). Results. The stricture rate was 54.5% (6/11). The median time until stricture development was 15 days. The median number of EBD sessions required was 2.5. The median duration of EBD was 14.5 days. AEs related to steroid pulse therapy and postprocedure complications were not observed. Conclusion. No preventive effect of the stricture after esophageal ESD by steroid pulse therapy was found, although the therapy was administered safely.