PS02.208: THE SHIELDING METHOD WITH POLYGLYCOLIC ACID SHEETS AND FIBRIN GLUE FOR PREVENTING ESOPHAGEAL STRICTURE AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION: A HISTORICAL CONTROL STUDY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 181-181
Author(s):  
Toshiro Iizuka ◽  
Daisuke Kikuchi ◽  
Yugo Suzuki ◽  
Shu Hoteya
Keyword(s):  
Fibrin Glue ◽  
Esophageal Stricture ◽  
Steroid Injection ◽  
Polyglycolic Acid ◽  
Control Group ◽  
Study Group ◽  
Group 4 ◽  
Stricture Rate ◽  
Intralesional Steroid ◽  
Intralesional Steroid Injection

Abstract Background There have been several reports that steroid administration are effective at preventing strictures after ESD. However, adverse events after steroid use are of great concern. We have reported that shielding with polyglycolic acid (PGA) sheets and fibrin glue can be useful for prevention of stricture after ESD. We conducted a retrospective analysis of efficiency of shielding with PGA sheets and fibrin glue for prevention of esophageal stricture compared with intralesional steroid injection. Methods ESD was performed on a total of 608 lesions in 553 patients for superficial esophageal cancer from January 2012 to March 2017. Of these, 45 lesions were enrolled in the study group (PGA sheets and fibrin glue) and 40 lesions were enrolled in the control group (intralesional steroid injection). The incidence of postoperative stricture at 6 weeks and the number of sessions of endoscopic balloon dilatation (EBD) required to resolve any strictures were evaluated. Among them, patients with additional surgery were excluded in both groups when investing the outcome. Results The post-ESD stricture rate was 10.5% in the study group (4/38 patients), which was not significantly lower than the stricture rate of 10.8% in the historical control group (4/37 patients; P = 0.63). The mean number of EBD was 1.2 ± 4.2 in the study group and 0.68 ± 2.2 in the control group, which was not significant (P = 0.47). Conclusion PGA sheets and fibrin glue appear to be a promising option for the prevention of esophageal stricture similar to the effect of intralesional steroid injection. Disclosure All authors have declared no conflicts of interest.

PS01.043: FACTORS EFFECT THE RESULT OF ESOPHAGEAL DILATION WITH INTRALESIONAL STEROID INJECTION IN SEVERE CORROSIVE STRICTURE PATIENTS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 61-62
Author(s):  
Supansa Chanana ◽  
Sirikan Limpakan (Yamada)
Keyword(s):  
Success Rate ◽  
Esophageal Stricture ◽  
Steroid Injection ◽  
Secondary Outcome ◽  
Esophageal Dilation ◽  
Intralesional Steroid ◽  
Intralesional Steroid Injection ◽  
Dilation Group ◽  
Corrosive Stricture ◽  
Grade Iii

Abstract Background Endoscopic esophageal dilation has been the primary therapy in severe corrosive stricture. There is a few study on effectiveness of intralesional steroid injection combined with esophageal dilation. The author studied factors that may give positive or negative effect results of dilation, and may extend the indication of dilation before definite surgery. Methods The authors reviewed the complete medical records as the retrospective study of patients those underwent intralesional steroid injection combined with esophageal dilation due to severe corrosive stricture. Primary outcome is the success rate of treatment by intralesion steroid injection combined with endoscopic esophageal stricture dilation. Secondary outcome is the risk that effect result of treatment. Statistical analysis was performed using STATA version 12 for Fisher's exact, students t-test, and relative risk regression, p-value of < 0.05 isconsidered as statistical significant. Results There are 55 patients was enrolled and presented with at least grade 4 of dysphagia, Marchand's grade III and IV from imaging stress review, and received intralesional steroid injection combined with endoscopic esophageal dilation. We divided patients into two groups, (1) a success esophageal dilation group (76.36%; mean number of dilation is 6 sessions/year), and (2) a failure esophageal dilation group whounderwent reconstruction surgery (23.64%). Patient characteristics including gender, age, time from transfer to the first dilation, type of corrosive agent, grading of dysphagia, number, length of lesion(s), and site of lesion(s). This study showed that gender, age, type of substance, number or length of stricture(s) had no significant difference about the result of treatment. Significant success factors are timing from first swallowing to first dilation (within 8 weeks, 78.57% success), no gastric deformity combined with esophageal stricture (90.48% success), and failure factor is the occurrence of complication during the period of treatment (69.23%) that mainly related to long segment of stricture more than 5 centimeters. Conclusion We gained high success rate in Marchand's grade III and IV by steroid injection combined with esophageal dilation. Predictors indicate that specific factor caused failure of treatment. The author extends the indication for endoscopic intervention in severe esophageal stricture before decision to do reconstructive surgery. Disclosure All authors have declared no conflicts of interest.

scholarly journals Evaluating the effect of injecting triamcinolone acetonide in two sessions for preventing esophageal stricture after endoscopic submucosal dissection

2019 ◽  
Vol 07 (06) ◽  
pp. E764-E770 ◽  
Author(s):  
Satoru Hashimoto ◽  
Ken-ichi Mizuno ◽  
Kazuya Takahashi ◽  
Hiroki Sato ◽  
Junji Yokoyama ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Triamcinolone Acetonide ◽  
Esophageal Stricture ◽  
Control Group ◽  
Study Group ◽  
Stricture Formation ◽  
Endoscopic Injection ◽  
Submucosal Dissection ◽  
Stricture Rate ◽  
Significant Difference

Abstract Background and study aims Several previous reports indicate that endoscopic injection of triamcinolone acetonide (TA) after widespread endoscopic submucosal dissection (ESD) is effective for preventing esophageal stricture. We investigated the efficacy of injecting TA in two sessions for preventing stricture formation post-ESD. Patients and methods Sixty-six consecutive patients with widespread mucosal defects that affected more than three-fourths of the circumference of the esophagus were included. The study group (n = 40) received TA injections over two sessions: immediately after and 14 days after ESD. The control group (n = 26) did not receive a TA injection. This study was performed retrospectively against historical controls. The primary endpoint of this study was frequency of stricture after TA injection. The secondary endpoint was number of required endoscopic balloon dilations (EBDs) after TA injection. Results The post-ESD stricture rate among patients who had subcircumferential mucosal defects was 45.7 % in the study group (16/35 patients), which was significantly lower than the rate of 73.9 % in the control group (17/23 patients; P = 0.031). The number of EBD procedures required was significantly lower in the study group (median 0, range 0 – 7) than in the control group (median 4, range 0 – 20; P < 0.001). There was no significant difference between the study and control groups among the patients who had full circumferential mucosal defects. Conclusion This study showed that performing two sessions of TA injection is an effective and safe treatment for prevention of esophageal stricture following subcircumferential ESD.

scholarly journals Preventing esophageal stricture after endoscopic submucosal dissection: steroid injection and shielding with polyglycolic acid sheets and fibrin glue

Endoscopy ◽  
2015 ◽  
Vol 47 (S 01) ◽  
pp. E473-E474 ◽  
Author(s):  
Yosuke Kataoka ◽  
Yosuke Tsuji ◽  
Yoshiki Sakaguchi ◽  
Shinya Kodashima ◽  
Nobutake Yamamichi ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Fibrin Glue ◽  
Esophageal Stricture ◽  
Steroid Injection ◽  
Polyglycolic Acid ◽  
Submucosal Dissection

The Efficacy of Skin Cooling for Pain Relief during Intralesional Steroid Injection for Keloid Treatment: A Randomized Cross-Over Study

2021 ◽  
Vol 104 (11) ◽  
pp. 1752-1757
Keyword(s):  
Treatment Group ◽  
Rating Scale ◽  
Steroid Injection ◽  
Pairwise Comparison ◽  
Random Order ◽  
Repeated Measure ◽  
Skin Cooling ◽  
Intralesional Steroid ◽  
Intralesional Steroid Injection ◽  
Pre Treatment

Objective: To evaluate if pre-treatment skin cooling can reduce the pain during steroid injection. Materials and Methods: A randomized cross-over study was conducted between September 2015 and October 2016. This study received ethical approval ID035904 No. MURA2016/152. Forty-four subjects with keloid that needed intralesional steroid injection were divided into three pretreatment groups, no treatment, skin cooling with ice pack, and skin applying with a mixture of lidocaine 2.5% and prilocaine 2.5% (EMLA®), in random order. Pain intensity was measured by using 100-mm visual analogue scale (VAS). The satisfaction levels were assessed with orderly interval rating scale from 1 to 5. Repeated-measure analysis of variance (ANOVA) and Bonferroni pairwise comparison were used for data analyses. Results: The mean VAS score at the time of needle puncturing into the skin and during steroid infiltration was statistically significant lower in skin cooling compared to no treatment group (p<0.001) and EMLA group (p<0.05). The satisfaction level was also statistically significant higher in skin cooling compared to no treatment group (p<0.001) and EMLA group (p<0.001). Thirty-seven patients (84%) selected skin cooling method as the most favorable pre-anesthetic method for intralesional steroid injection. Conclusion: Skin cooling with ice before intralesional steroid injection of keloid effectively reduces pain and patients are also satisfied. Keyword: Keloid, Corticosteroid, Pre-treatment, pain, skin cooling

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