Esophageal endoscopic submucosal dissection (ESD) is a very common and useful endoscopic treatment for superficial esophageal cancer 1 . The most common delayed adverse event of esophageal ESD for extensive lesions is stenosis 2 . Local injection of triamcinolone is the most common form of stenosis prevention 3 , and the method using a needle is a rather complicated and time-consuming procedure. A new drug-delivery balloon catheter is a device with multiple micro holes on its surface that eject fluid from the balloon when the balloon pressure rises.
A man in his 60s underwent ESD for semiperipheral superficial esophageal cancer in the upper thoracic esophagus ( Fig. 1 ). The resected pathology was squamous cell carcinoma, and curative resection was obtained. After resection, the mucosal defect extended to 7/8 of the circumference ( Fig. 2 ), and triamcinolone 40 mg was injected into the post-treatment ulcer using the new drug-delivery balloon catheter ( Video 1 ).
The procedure was completed in only a few minutes, and was very safe and simple. Post-procedure observation showed that triamcinolone was injected evenly and firmly into the ulcer ( Fig. 3 ).
A new drug-delivery balloon catheter allows for safe, simple, and quick triamcinolone injection after esophageal ESD.
Endoscopy_UCTN_Code_TTT_1AO_2AG_3AD
Acknowledgement
We would like to thank Kaoru Kamiya, Tatsumichi Fujiwara, Hiroaki Usukura, Katsumi Kanda, Takashi Kato, Tatsuya Okubo, and the rest of the Tokai Medical Products staff.
Footnotes
Conflict of Interest The authors declare that they have no conflict of interest.
Endoscopy E-Videos https://eref.thieme.de/e-videos .
E-Videos is an open access online section of the journal Endoscopy , reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high-quality video and are published with a Creative Commons CC-BY license. Endoscopy E-Videos qualify for HINARI discounts and waivers and eligibility is automatically checked during the submission process. We grant 100% waivers to articles whose corresponding authors are based in Group A countries and 50% waivers to those who are based in Group B countries as classified by Research4Life (see: https://www.research4life.org/access/eligibility/ ). This section has its own submission website at https://mc.manuscriptcentral.com/e-videos .
References
- 1.Inoue H, Minami H, Kaga M et al. Endoscopic mucosal resection and endoscopic submucosal dissection for esophageal dysplasia and carcinoma. Gastrointest Endosc Clin N Am. 2010;20:25–34, v-vi. doi: 10.1016/j.giec.2009.08.005. [DOI] [PubMed] [Google Scholar]
- 2.Ishihara R. Prevention of esophageal stricture after endoscopic resection. Dig Endosc. 2019;31:134–145. doi: 10.1111/den.13296. [DOI] [PubMed] [Google Scholar]
- 3.Miyake M, Ishihara R, Matsuura N et al. Predictors of stricture after non-circumferential endoscopic submucosal dissection of the esophagus and single-dose triamcinolone injection immediately after the procedure. Gastrointest Endosc. 2023;98:170–177. doi: 10.1016/j.gie.2023.03.017. [DOI] [PubMed] [Google Scholar]