Qi Lei, He Wei, Yang Jing, Gao Yuan, Chen Jianping
Department of Gastroenterology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213003, P.R. China.
Exp Ther Med. 2018 Dec;16(6):5248-5252. doi: 10.3892/etm.2018.6858. Epub 2018 Oct 12.
Effect and prognosis of endoscopic balloon dilatation combined with submucosal triamcinolone acetonide on treating benign esophageal lesions were explored. This retrospective study included patients with esophageal stricture treated in the Department of Gastroenterology, the Third Affiliated Hospital of Soochow University from March 2012 to March 2015. Enrolled patients were divided into the treatment and control group depending on the therapy differences. Endoscopic balloon dilation combined with submucosal injection of triamcinolone acetonide was performed in the treatment group and the endoscopic balloon dilatation was performed in the control group. In addition, the treatment group was further divided into the <16- and >16-mm subgroup according to the degree of balloon dilatation. During 1-year follow-up, changes of esophageal stenosis, esophageal stenosis recurrence rate, postoperative complications and adverse reactions were observed and analyzed. The improvement of esophageal stenosis of the treatment group was significantly superior to that of the control group at 2 and 4 months after operation, respectively (P=0.002, 0.013). The esophageal stenosis recurrence rate was 62.2 and 77.2% in the treatment and control group, respectively (P=0.027); the recurrence time of stenosis was 101.4±8.6 days in the treatment group and 75.4±5.2 days in the control group (P=0.006). Additionally, the recurrence time of esophageal stenosis was significantly shorter in the >16-mm subgroup compared with that of the <16-mm subgroup (P<0.001). Endoscopic balloon dilatation combined with local injection of triamcinolone acetonide in the treatment of esophageal stricture had a better therapeutic effect than that of the simple balloon dilatation, which was more effective when the balloon dilatation was >16 mm. It could significantly prolong the recurrence time of esophageal stricture.
探讨内镜下球囊扩张联合曲安奈德黏膜下注射治疗良性食管病变的疗效及预后。本回顾性研究纳入2012年3月至2015年3月在苏州大学附属第三医院胃肠科接受治疗的食管狭窄患者。根据治疗差异将入选患者分为治疗组和对照组。治疗组采用内镜下球囊扩张联合曲安奈德黏膜下注射，对照组仅行内镜下球囊扩张。此外，治疗组根据球囊扩张程度进一步分为<16 mm亚组和>16 mm亚组。在1年的随访期间，观察并分析食管狭窄的变化、食管狭窄复发率、术后并发症及不良反应。治疗组术后2个月和4个月食管狭窄的改善情况分别显著优于对照组（P = 0.002，0.013）。治疗组和对照组的食管狭窄复发率分别为62.2%和77.2%（P = 0.027）；治疗组狭窄复发时间为101.4±8.6天，对照组为75.4±5.2天（P = 0.006）。此外，>16 mm亚组食管狭窄的复发时间明显短于<16 mm亚组（P<0.001）。内镜下球囊扩张联合曲安奈德局部注射治疗食管狭窄的疗效优于单纯球囊扩张，球囊扩张>16 mm时效果更佳。它可显著延长食管狭窄的复发时间。
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