Blasberg Tobias, Meiborg Moritz, Richl Johannes, Weber Marie, Hiebel Lukas, Mekolli Ardian, Seif Amir Hosseini Ali, Amanzada Ahmad, Ellenrieder Volker, Hochberger Jürgen, Wedi Edris
Division of Gastroenterology, Gastrointestinal Oncology and Interventional Endoscopy, Sana Clinic Offenbach, Offenbach, Germany.
Clinic for Gastroenterology, Gastrointestinal Oncology and Endocrinology, University of Göttingen, Göttingen, Germany.
Gastrointest Endosc. 2025 Mar;101(3):650-654. doi: 10.1016/j.gie.2024.08.011. Epub 2024 Sep 10.
Esophageal stricture is a severe adverse event after wide-field endoscopic submucosal dissection (ESD) of superficial esophageal carcinoma. This study evaluated the efficacy and safety of combining endoscopic vacuum therapy (EVT) and a budesonide orodispersible tablet (BOT) in preventing post-ESD strictures.
This prospective case series included patients with superficial esophageal squamous cell carcinoma and adenocarcinoma who had wide-field ESD (≥75% circumference, resection length ≥50 mm). After ESD, EVT was applied immediately followed by 8 weeks of BOTs. The main outcome measurement was the incidence of post-ESD stricture.
Eleven patients underwent ESD. Of these, 81.8% had 75% to 99% circumference resected and 18.2% had a circumferential resection. EVT remained in situ for a mean of 3.5 days. No esophageal strictures were observed by the final follow-up, and no major adverse events occurred related to EVT or the BOT.
The prophylactic combination of EVT and BOT is a novel and promising strategy for reducing post-ESD strictures.
食管狭窄是浅表性食管癌广泛内镜下黏膜下剥离术（ESD）后的严重不良事件。本研究评估了内镜下负压治疗（EVT）联合布地奈德口腔崩解片（BOT）预防ESD术后狭窄的有效性和安全性。
本前瞻性病例系列纳入了接受广泛ESD（环周切除≥75%，切除长度≥50 mm）的浅表性食管鳞状细胞癌和腺癌患者。ESD术后立即应用EVT，随后服用8周BOT。主要观察指标为ESD术后狭窄的发生率。
11例患者接受了ESD。其中，81.8%的患者环周切除75%至99%，18.2%的患者进行了环周切除。EVT平均留置原位3.5天。末次随访时未观察到食管狭窄，也未发生与EVT或BOT相关的重大不良事件。
EVT与BOT联合预防性应用是减少ESD术后狭窄的一种新颖且有前景的策略。
