Triamcinolone injection after balloon dilation is useful for esophageal stricture caused by ESD

Aims Multiple endoscopic balloon dilatation (EBD) is sometimes required to resolve esophageal stricture due to endoscopic submucosal dissection (ESD). There have been no data about the efficacy of steroid injection after EBD. We evaluated the efficacy of triamcinolone injection after EBD for esophageal stricture caused by ESD. Methods This was a single center retrospective study. Between 2008 and 2020, 98 consecutive patients were treated with EBD for esophageal stricture caused by ESD. Inclusion was patients who had esophageal stricture despite they received steroid injection immediately after ESD. Patients with addition esophagectomy, with previous chemoradiotherapy, and with cervical esophageal cancer were excluded. Outcome measure were the cumulative stricture resolving rate, the median time and the number of EBD required to resolve the stricture. Results Seventy patients had esophageal stricture despite they received steroid injection after ESD. After exclusion, 8 received EBD without steroid injection, 34 received triamcinolone injection after EBD. No significant differences were found in background characteristics. Steroid injection decreased median time required to resolve the stricture (214.0 vs 59.5 days, p=0.047) and the number of EBD (6.0 vs 2.0, p=0.006). Cumulative stricture resolving rates of 3 months, and 6 months were 37.5% vs 61.8%, and 50.0% vs 73.5% (log rank test p=0.055). Using inverse probability of treatment weighting, EBD with steroid injection resolved stricture more than without steroid (HR, 2.19; 95% CI, 1.00-4.79; P=0.049, log rank P=0.04). Conclusions Triamcinolone injection after EBD may effective to resolve esophageal stricture due to ESD. Publication History Article published online: 14 April 2023 © 2023. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany