Endoscopic radial incision combined with local injection of triamcinolone acetonide for refractory esophageal stenosis after endoscopy submucosal dissection.

Abstract

Refractory esophageal stenosis (RES) after endoscopic submucosal dissection (ESD) is challenging in clinical practice. This study aimed to evaluate endoscopic radial incision (ERI) combined with the local injection of triamcinolone acetonide for RES and to assess its safety and efficacy. A total of nine patients (five males; age range: 50-76 years) who underwent ERI + triamcinolone acetonide for RES after ESD between August 2019 and November 2022 were analyzed. The primary endpoint was the duration of treatment. The length of the stenosed portion, procedure time, sessions of endoscopic therapy, effectiveness rate, success rate, dysphagia grade, complications, and quality of scores were also analyzed. The effectiveness and success rates were 100% and 88.9%, respectively. The mean number of sessions of ERI + triamcinolone acetonide was 2.2 (1.0-4.0). The mean procedure time was 25.9 ± 3.8 min. No severe complications, including bleeding or perforation, were observed during the perioperative period. Dysphagia symptoms were relieved in all patients after endoscopic treatment. Patients had significantly better functional scales for social functioning and global health status and lower rates of fatigue, gastrointestinal symptoms, and financial difficulties after treatment. ERI + triamcinolone acetonide can be considered a safe and effective treatment for RES after ESD. Larger prospective clinical trials are needed to confirm its utility.