Theme |
Towards Standardization of ESD Procedures |
Title |
The Strategy for Post ESD Stenosis in the Superficial Esophageal Cancer -- The Stenosis Prevention Treatment—resistant Factor, and Usefulness of Steroid Oral + Local Injection Combination Therapy |
Author |
Naoyuki Yamaguchi |
Department of Endoscopy, Nagasaki University Hospital |
Author |
Ken Ohnita |
Department of Endoscopy, Nagasaki University Hospital |
Author |
Kazuhiko Nakao |
Gastroenterology and Hepatology, Nagasaki University Hospital |
Author |
Susumu Eguchi |
2nd Department of Surgery, Nagasaki University Hospital |
Author |
Hajime Isomoto |
2nd Department of Medicine, Tottori University Hospital |
Author |
Nobuo Kanai |
Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University |
Author |
Takeshi Ohki |
Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University |
Author |
Masayuki Yamato |
Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University |
[ Summary ] |
Endoscopic submucosal dissection (ESD) for superficial esophageal squamous cell carcinoma is gradually becoming a standard procedure since being covered by the Japanese national health insurance in 2008. However, post procedural stricture is common after ESD for extensive tumors, especially in cases that undergo complete or semi‒complete circular dissection. These cases are challenging because multiple endoscopic balloon dilation (EBD) would be required for treatment of the stricture. We have reported that systemic, local steroid administration, and cell sheet transplantation therapy reduced the frequency of EBD. In this article, we investigated the usefulness and limitations of steroid administration and cell sheet transplantation in order to prevent post‒ESD stenosis. In addition more, we clarified the usefulness of SH oral + local injection combination therapy for these stenosis prevention treatment‒resistant cases. |