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Prospective multicenter study of the esophageal triamcinolone acetonide‐filling method in patients with subcircumferential esophageal endoscopic submucosal dissection
Background and Aim The esophageal triamcinolone acetonide (TA)‐filling method is a novel local approach for stenosis prevention after extensive esophageal endoscopic submucosal dissection (ESD). We evaluated this method after subcircumferential ESD. Methods We enrolled 20 patients with esophageal ca...
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| Published in: | Digestive endoscopy 2020-03, Vol.32 (3), p.355-363 |
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| cites | cdi_FETCH-LOGICAL-c3496-2f9f8ac21960232e8cc959773735f3fcfa56e19a1d19af729357d53576cf0c023 |
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| container_title | Digestive endoscopy |
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| creator | Shibagaki, Kotaro Yuki, Takafumi Taniguchi, Hideaki Aimi, Masahito Miyaoka, Yoichi Yuki, Mika Ishimura, Norihisa Oshima, Naoki Mishiro, Tsuyoshi Tamagawa, Yuji Mikami, Hironobu Izumi, Daisuke Yamashita, Noritsugu Sato, Shuichi Ishihara, Shunji Kinoshita, Yoshikazu |
| description | Background and Aim
The esophageal triamcinolone acetonide (TA)‐filling method is a novel local approach for stenosis prevention after extensive esophageal endoscopic submucosal dissection (ESD). We evaluated this method after subcircumferential ESD.
Methods
We enrolled 20 patients with esophageal cancer requiring subcircumferential ESD in a prospective multicenter study. Esophageal TA filling was carried out 1 day and 1 week after ESD, with follow‐up endoscopy every 2 weeks. We treated severe stenosis preventing endoscope passage with endoscopic balloon dilatation (EBD) and additional TA filling, and mild stenosis allowing endoscope passage with additional TA filling only. Primary endpoint was incidence of severe stenosis; secondary endpoints were total number of EBD, rate of additional TA filling, time to stenosis and complete re‐epithelialization, dysphagia score, and adverse events. Horizontal resection grade was divided into grades 1 (≥ 9/12 and |
| doi_str_mv | 10.1111/den.13496 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2267406172</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2267406172</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3496-2f9f8ac21960232e8cc959773735f3fcfa56e19a1d19af729357d53576cf0c023</originalsourceid><addsrcrecordid>eNp1kcFuFSEUhonR2NvqwhcwLHUx7QADU5amVmvStF3oeoKHQy-GgXFgbO7OR_AxfC6fRMZbGzeyOCQnH18O5yfkBWuPWT0nFuMxE51Wj8iGdZ1omFLsMdm0mslGKiEPyGHOX9qWcd11T8mBYEIxzeWG_LyZU54Qiv-GdFxC8YCx4ExzWeyOJkfLFinmNG3NLZpAy-zNCD6mkCJSA1hS9BZ_ff_hfAg-3tIRyzZZ6iOdTPHVlumdL1ual8_gZ1hGh3Pt-ir7x4vRpgxp8rCC4wIp1671Oa_DpfiMPHEmZHx-fx-RT-_OP55dNJfX7z-cvblsYF1Aw512pwY406rlguMpgJa670UvpBMOnJEKmTbM1uJ6roXsraxFgWuhPjkir_beaU5fF8xlGH0GDMFETEseOFd91yrWr-jrPQp1h3lGN0yzH828G1g7rMEMNZjhTzCVfXmvrZ9D-0D-TaICJ3vgzgfc_d80vD2_2it_A993ngA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2267406172</pqid></control><display><type>article</type><title>Prospective multicenter study of the esophageal triamcinolone acetonide‐filling method in patients with subcircumferential esophageal endoscopic submucosal dissection</title><source>Wiley-Blackwell Journals</source><creator>Shibagaki, Kotaro ; Yuki, Takafumi ; Taniguchi, Hideaki ; Aimi, Masahito ; Miyaoka, Yoichi ; Yuki, Mika ; Ishimura, Norihisa ; Oshima, Naoki ; Mishiro, Tsuyoshi ; Tamagawa, Yuji ; Mikami, Hironobu ; Izumi, Daisuke ; Yamashita, Noritsugu ; Sato, Shuichi ; Ishihara, Shunji ; Kinoshita, Yoshikazu</creator><creatorcontrib>Shibagaki, Kotaro ; Yuki, Takafumi ; Taniguchi, Hideaki ; Aimi, Masahito ; Miyaoka, Yoichi ; Yuki, Mika ; Ishimura, Norihisa ; Oshima, Naoki ; Mishiro, Tsuyoshi ; Tamagawa, Yuji ; Mikami, Hironobu ; Izumi, Daisuke ; Yamashita, Noritsugu ; Sato, Shuichi ; Ishihara, Shunji ; Kinoshita, Yoshikazu</creatorcontrib><description>Background and Aim
The esophageal triamcinolone acetonide (TA)‐filling method is a novel local approach for stenosis prevention after extensive esophageal endoscopic submucosal dissection (ESD). We evaluated this method after subcircumferential ESD.
Methods
We enrolled 20 patients with esophageal cancer requiring subcircumferential ESD in a prospective multicenter study. Esophageal TA filling was carried out 1 day and 1 week after ESD, with follow‐up endoscopy every 2 weeks. We treated severe stenosis preventing endoscope passage with endoscopic balloon dilatation (EBD) and additional TA filling, and mild stenosis allowing endoscope passage with additional TA filling only. Primary endpoint was incidence of severe stenosis; secondary endpoints were total number of EBD, rate of additional TA filling, time to stenosis and complete re‐epithelialization, dysphagia score, and adverse events. Horizontal resection grade was divided into grades 1 (≥ 9/12 and <10/12 of the circumference), 2 (≥ 10/12 and <11/12), and 3 (≥ 11/12 but not circumferential) and analyzed statistically for correlation with endpoints.
Results
Incidence of severe stenosis was 5.0% (1/20; 0.1–24.8%) and was treated with three EBD. Six patients showed mild stenosis. Additional TA filling was carried out in these seven patients: 0% (0/9) for grade 1 resection, 40% (2/5) for grade 2, and 83% (5/6) for grade 3 (P < 0.05). Median time to stenosis and re‐epithelialization was 3 and 7 weeks, respectively. Dysphagia score deteriorated in one patient. No adverse events occurred.
Conclusions
The esophageal TA‐filling method prevented stenosis after subcircumferential ESD. Grade ≥2 resection showed a high risk for stenosis, but additional TA filling for mild stenosis inhibited stenosis progression (UMIN000024384).</description><identifier>ISSN: 0915-5635</identifier><identifier>EISSN: 1443-1661</identifier><identifier>DOI: 10.1111/den.13496</identifier><identifier>PMID: 31361925</identifier><language>eng</language><publisher>Australia</publisher><subject>Aged ; Aged, 80 and over ; Anti-Inflammatory Agents - administration & dosage ; Carcinoma - pathology ; Carcinoma - surgery ; Endoscopic Mucosal Resection - adverse effects ; endoscopic submucosal dissection ; Esophageal Neoplasms - pathology ; Esophageal Neoplasms - surgery ; esophageal stenosis ; Esophageal Stenosis - epidemiology ; Esophageal Stenosis - prevention & control ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications - epidemiology ; Postoperative Complications - prevention & control ; prevention ; Prospective Studies ; Reproducibility of Results ; steroid ; triamcinolone acetonide ; Triamcinolone Acetonide - administration & dosage</subject><ispartof>Digestive endoscopy, 2020-03, Vol.32 (3), p.355-363</ispartof><rights>2019 Japan Gastroenterological Endoscopy Society</rights><rights>2019 Japan Gastroenterological Endoscopy Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3496-2f9f8ac21960232e8cc959773735f3fcfa56e19a1d19af729357d53576cf0c023</citedby><cites>FETCH-LOGICAL-c3496-2f9f8ac21960232e8cc959773735f3fcfa56e19a1d19af729357d53576cf0c023</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fden.13496$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fden.13496$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,786,790,27957,27958,50923,51032</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31361925$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shibagaki, Kotaro</creatorcontrib><creatorcontrib>Yuki, Takafumi</creatorcontrib><creatorcontrib>Taniguchi, Hideaki</creatorcontrib><creatorcontrib>Aimi, Masahito</creatorcontrib><creatorcontrib>Miyaoka, Yoichi</creatorcontrib><creatorcontrib>Yuki, Mika</creatorcontrib><creatorcontrib>Ishimura, Norihisa</creatorcontrib><creatorcontrib>Oshima, Naoki</creatorcontrib><creatorcontrib>Mishiro, Tsuyoshi</creatorcontrib><creatorcontrib>Tamagawa, Yuji</creatorcontrib><creatorcontrib>Mikami, Hironobu</creatorcontrib><creatorcontrib>Izumi, Daisuke</creatorcontrib><creatorcontrib>Yamashita, Noritsugu</creatorcontrib><creatorcontrib>Sato, Shuichi</creatorcontrib><creatorcontrib>Ishihara, Shunji</creatorcontrib><creatorcontrib>Kinoshita, Yoshikazu</creatorcontrib><title>Prospective multicenter study of the esophageal triamcinolone acetonide‐filling method in patients with subcircumferential esophageal endoscopic submucosal dissection</title><title>Digestive endoscopy</title><addtitle>Dig Endosc</addtitle><description>Background and Aim
The esophageal triamcinolone acetonide (TA)‐filling method is a novel local approach for stenosis prevention after extensive esophageal endoscopic submucosal dissection (ESD). We evaluated this method after subcircumferential ESD.
Methods
We enrolled 20 patients with esophageal cancer requiring subcircumferential ESD in a prospective multicenter study. Esophageal TA filling was carried out 1 day and 1 week after ESD, with follow‐up endoscopy every 2 weeks. We treated severe stenosis preventing endoscope passage with endoscopic balloon dilatation (EBD) and additional TA filling, and mild stenosis allowing endoscope passage with additional TA filling only. Primary endpoint was incidence of severe stenosis; secondary endpoints were total number of EBD, rate of additional TA filling, time to stenosis and complete re‐epithelialization, dysphagia score, and adverse events. Horizontal resection grade was divided into grades 1 (≥ 9/12 and <10/12 of the circumference), 2 (≥ 10/12 and <11/12), and 3 (≥ 11/12 but not circumferential) and analyzed statistically for correlation with endpoints.
Results
Incidence of severe stenosis was 5.0% (1/20; 0.1–24.8%) and was treated with three EBD. Six patients showed mild stenosis. Additional TA filling was carried out in these seven patients: 0% (0/9) for grade 1 resection, 40% (2/5) for grade 2, and 83% (5/6) for grade 3 (P < 0.05). Median time to stenosis and re‐epithelialization was 3 and 7 weeks, respectively. Dysphagia score deteriorated in one patient. No adverse events occurred.
Conclusions
The esophageal TA‐filling method prevented stenosis after subcircumferential ESD. Grade ≥2 resection showed a high risk for stenosis, but additional TA filling for mild stenosis inhibited stenosis progression (UMIN000024384).</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Inflammatory Agents - administration & dosage</subject><subject>Carcinoma - pathology</subject><subject>Carcinoma - surgery</subject><subject>Endoscopic Mucosal Resection - adverse effects</subject><subject>endoscopic submucosal dissection</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophageal Neoplasms - surgery</subject><subject>esophageal stenosis</subject><subject>Esophageal Stenosis - epidemiology</subject><subject>Esophageal Stenosis - prevention & control</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>prevention</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>steroid</subject><subject>triamcinolone acetonide</subject><subject>Triamcinolone Acetonide - administration & dosage</subject><issn>0915-5635</issn><issn>1443-1661</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kcFuFSEUhonR2NvqwhcwLHUx7QADU5amVmvStF3oeoKHQy-GgXFgbO7OR_AxfC6fRMZbGzeyOCQnH18O5yfkBWuPWT0nFuMxE51Wj8iGdZ1omFLsMdm0mslGKiEPyGHOX9qWcd11T8mBYEIxzeWG_LyZU54Qiv-GdFxC8YCx4ExzWeyOJkfLFinmNG3NLZpAy-zNCD6mkCJSA1hS9BZ_ff_hfAg-3tIRyzZZ6iOdTPHVlumdL1ual8_gZ1hGh3Pt-ir7x4vRpgxp8rCC4wIp1671Oa_DpfiMPHEmZHx-fx-RT-_OP55dNJfX7z-cvblsYF1Aw512pwY406rlguMpgJa670UvpBMOnJEKmTbM1uJ6roXsraxFgWuhPjkir_beaU5fF8xlGH0GDMFETEseOFd91yrWr-jrPQp1h3lGN0yzH828G1g7rMEMNZjhTzCVfXmvrZ9D-0D-TaICJ3vgzgfc_d80vD2_2it_A993ngA</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Shibagaki, Kotaro</creator><creator>Yuki, Takafumi</creator><creator>Taniguchi, Hideaki</creator><creator>Aimi, Masahito</creator><creator>Miyaoka, Yoichi</creator><creator>Yuki, Mika</creator><creator>Ishimura, Norihisa</creator><creator>Oshima, Naoki</creator><creator>Mishiro, Tsuyoshi</creator><creator>Tamagawa, Yuji</creator><creator>Mikami, Hironobu</creator><creator>Izumi, Daisuke</creator><creator>Yamashita, Noritsugu</creator><creator>Sato, Shuichi</creator><creator>Ishihara, Shunji</creator><creator>Kinoshita, Yoshikazu</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202003</creationdate><title>Prospective multicenter study of the esophageal triamcinolone acetonide‐filling method in patients with subcircumferential esophageal endoscopic submucosal dissection</title><author>Shibagaki, Kotaro ; Yuki, Takafumi ; Taniguchi, Hideaki ; Aimi, Masahito ; Miyaoka, Yoichi ; Yuki, Mika ; Ishimura, Norihisa ; Oshima, Naoki ; Mishiro, Tsuyoshi ; Tamagawa, Yuji ; Mikami, Hironobu ; Izumi, Daisuke ; Yamashita, Noritsugu ; Sato, Shuichi ; Ishihara, Shunji ; Kinoshita, Yoshikazu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3496-2f9f8ac21960232e8cc959773735f3fcfa56e19a1d19af729357d53576cf0c023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Inflammatory Agents - administration & dosage</topic><topic>Carcinoma - pathology</topic><topic>Carcinoma - surgery</topic><topic>Endoscopic Mucosal Resection - adverse effects</topic><topic>endoscopic submucosal dissection</topic><topic>Esophageal Neoplasms - pathology</topic><topic>Esophageal Neoplasms - surgery</topic><topic>esophageal stenosis</topic><topic>Esophageal Stenosis - epidemiology</topic><topic>Esophageal Stenosis - prevention & control</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>prevention</topic><topic>Prospective Studies</topic><topic>Reproducibility of Results</topic><topic>steroid</topic><topic>triamcinolone acetonide</topic><topic>Triamcinolone Acetonide - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shibagaki, Kotaro</creatorcontrib><creatorcontrib>Yuki, Takafumi</creatorcontrib><creatorcontrib>Taniguchi, Hideaki</creatorcontrib><creatorcontrib>Aimi, Masahito</creatorcontrib><creatorcontrib>Miyaoka, Yoichi</creatorcontrib><creatorcontrib>Yuki, Mika</creatorcontrib><creatorcontrib>Ishimura, Norihisa</creatorcontrib><creatorcontrib>Oshima, Naoki</creatorcontrib><creatorcontrib>Mishiro, Tsuyoshi</creatorcontrib><creatorcontrib>Tamagawa, Yuji</creatorcontrib><creatorcontrib>Mikami, Hironobu</creatorcontrib><creatorcontrib>Izumi, Daisuke</creatorcontrib><creatorcontrib>Yamashita, Noritsugu</creatorcontrib><creatorcontrib>Sato, Shuichi</creatorcontrib><creatorcontrib>Ishihara, Shunji</creatorcontrib><creatorcontrib>Kinoshita, Yoshikazu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shibagaki, Kotaro</au><au>Yuki, Takafumi</au><au>Taniguchi, Hideaki</au><au>Aimi, Masahito</au><au>Miyaoka, Yoichi</au><au>Yuki, Mika</au><au>Ishimura, Norihisa</au><au>Oshima, Naoki</au><au>Mishiro, Tsuyoshi</au><au>Tamagawa, Yuji</au><au>Mikami, Hironobu</au><au>Izumi, Daisuke</au><au>Yamashita, Noritsugu</au><au>Sato, Shuichi</au><au>Ishihara, Shunji</au><au>Kinoshita, Yoshikazu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective multicenter study of the esophageal triamcinolone acetonide‐filling method in patients with subcircumferential esophageal endoscopic submucosal dissection</atitle><jtitle>Digestive endoscopy</jtitle><addtitle>Dig Endosc</addtitle><date>2020-03</date><risdate>2020</risdate><volume>32</volume><issue>3</issue><spage>355</spage><epage>363</epage><pages>355-363</pages><issn>0915-5635</issn><eissn>1443-1661</eissn><notes>ObjectType-Article-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-1</notes><notes>content type line 23</notes><abstract>Background and Aim
The esophageal triamcinolone acetonide (TA)‐filling method is a novel local approach for stenosis prevention after extensive esophageal endoscopic submucosal dissection (ESD). We evaluated this method after subcircumferential ESD.
Methods
We enrolled 20 patients with esophageal cancer requiring subcircumferential ESD in a prospective multicenter study. Esophageal TA filling was carried out 1 day and 1 week after ESD, with follow‐up endoscopy every 2 weeks. We treated severe stenosis preventing endoscope passage with endoscopic balloon dilatation (EBD) and additional TA filling, and mild stenosis allowing endoscope passage with additional TA filling only. Primary endpoint was incidence of severe stenosis; secondary endpoints were total number of EBD, rate of additional TA filling, time to stenosis and complete re‐epithelialization, dysphagia score, and adverse events. Horizontal resection grade was divided into grades 1 (≥ 9/12 and <10/12 of the circumference), 2 (≥ 10/12 and <11/12), and 3 (≥ 11/12 but not circumferential) and analyzed statistically for correlation with endpoints.
Results
Incidence of severe stenosis was 5.0% (1/20; 0.1–24.8%) and was treated with three EBD. Six patients showed mild stenosis. Additional TA filling was carried out in these seven patients: 0% (0/9) for grade 1 resection, 40% (2/5) for grade 2, and 83% (5/6) for grade 3 (P < 0.05). Median time to stenosis and re‐epithelialization was 3 and 7 weeks, respectively. Dysphagia score deteriorated in one patient. No adverse events occurred.
Conclusions
The esophageal TA‐filling method prevented stenosis after subcircumferential ESD. Grade ≥2 resection showed a high risk for stenosis, but additional TA filling for mild stenosis inhibited stenosis progression (UMIN000024384).</abstract><cop>Australia</cop><pmid>31361925</pmid><doi>10.1111/den.13496</doi><tpages>9</tpages></addata></record> |
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| ispartof | Digestive endoscopy, 2020-03, Vol.32 (3), p.355-363 |
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| source | Wiley-Blackwell Journals |
| subjects | Aged Aged, 80 and over Anti-Inflammatory Agents - administration & dosage Carcinoma - pathology Carcinoma - surgery Endoscopic Mucosal Resection - adverse effects endoscopic submucosal dissection Esophageal Neoplasms - pathology Esophageal Neoplasms - surgery esophageal stenosis Esophageal Stenosis - epidemiology Esophageal Stenosis - prevention & control Female Humans Male Middle Aged Postoperative Complications - epidemiology Postoperative Complications - prevention & control prevention Prospective Studies Reproducibility of Results steroid triamcinolone acetonide Triamcinolone Acetonide - administration & dosage |
| title | Prospective multicenter study of the esophageal triamcinolone acetonide‐filling method in patients with subcircumferential esophageal endoscopic submucosal dissection |
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