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

Figure 4

Endoscopic images of a representative patient with stricture after steroid pulse therapy. (a) An image of the esophagus stained with iodine immediately before ESD showing a type 0–IIc squamous cell carcinoma in the middle thoracic esophagus is shown. (b) An image obtained immediately after ESD showing no perforation or exposed muscle layer after en bloc resection is shown. The mucosal defect involved greater than seven-eighths of the esophageal circumference. (c) An ESD-resected specimen stained with iodine is shown. The longitudinal resected specimen size was 70 mm. (d) An image obtained 14 days after ESD is shown. The patient experienced dysphagia and was endoscopically found to have stricture that required endoscopic balloon dilation (EBD). (e) An image obtained 28 days after ESD is shown. An endoscope could not be passed through the esophagus, and the patient underwent additional EBD sessions. In all, 6 EBD sessions were ultimately performed. (f) An image obtained 6 months after ESD showing complete epithelialization of the post-ESD ulcer without stricture is shown.

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