KEY TAKEAWAYS
- The study aimed to compare oral prednisolone alone vs. prednisolone plus nasogastric tube for preventing esophageal stricture after ESD.
- Researchers found that combining steroids with NGT is more effective than oral steroids alone for preventing esophageal stricture.
Effective and safe methods for preventing esophageal stricture after large endoscopic submucosal dissection (ESD) in patients with superficial esophageal cancer are lacking.
Lihong Teng and the team aimed to compare the effectiveness of oral prednisolone alone vs. combined oral prednisolone and nasogastric tube in preventing esophageal stricture after extensive ESD.
Clinical data were retrospectively collected from a single center on patients with early esophageal cancer who underwent ESD. Patients were divided into 2 groups including the steroid group, which received only oral prednisolone, and the steroid-plus-nasogastric tube (NGT) group. The study analyzed the incidence of esophageal stricture and identified risk factors for its development.
Of 79 patients, 30 were in the steroid group and 49 in the steroid + nasogastric tube retention (NGT) group. The incidence of stricture was significantly higher in the steroid group (9 of 30, 30.0%) compared to the steroid + NGT group (3 of 49, 6.1%) (P= .004). A notable difference in stricture rates was observed between the 2 groups, especially among patients with a complete circumferential defect (100% vs. 16.7%) (P= .015).
Multivariate logistic regression analysis identified a full circumferential defect of the esophageal mucosa (OR 12.501; 95% CI 1.907, 81.047; P= .008), invasion depth beyond the lamina propria (OR 5.635; 95% CI 1.039, 30.559; P= .045), and absence of NGT retention (OR 12.896; 95% CI 2.099, 79.219; P= .006) as independent risk factors for stricture development.
The study concluded that combining steroids with NGT retention is more effective than using oral steroids alone for preventing esophageal stricture after extensive ESD.
Funding information was not available.
Source: https://pubmed.ncbi.nlm.nih.gov/39128118/
Teng L, Yang X, Ding J. (2024). “Comparison of the Prevention of Esophageal Stricture Between Oral Prednisolone Alone and Oral Prednisolone Combined with Nasogastric Tube in Superficial Esophageal Cancer After Endoscopic Submucosal Dissection.” Turk J Gastroenterol. 2024;35(6):481-487. doi:10.5152/tjg.2024.23487
