Table 3.
Effect of preventive steroid therapy after non-total circumferential endoscopic submucosal dissection for esophageal squamous cell carcinoma.
| Author | Year | Study Design | Drugs | Dose | Timing of Intervention | Mucosal Defect Circumference | Incidence of Stricture |
|---|---|---|---|---|---|---|---|
| Steroid injection | |||||||
| Hashimoto [21] | 2011 | Retrospective | TA | 18–62 mg | Day 3, 7, 10 (3 times) | >3/4 | 19% (4/21) |
| Hanaoka [23] | 2012 | Prospective | TA | 100 mg | Day 0 | >3/4 | 10% (3/30) |
| Yamaguchi [33] | 2013 | Retrospective | TA | 40 mg (<3 cm in longitudinal mucosal defect), 80 mg (≥ 3 cm) | Day 0 (>9/10 in circumference or ≥5 cm in longitudinal mucosal defect: additionally Day 21) | >3/4 | 4.3% (1/23) |
| Takahashi [24] | 2015 | Prospective, randomized |
TA | 40 mg | Day 0 | >2/3 (lesion *) | 45.5% (5/11) |
| Hanaoka [34] | 2016 | Retrospective | TA | 50–100 mg | Day 0 | >3/4 | 11.3% (13/115) |
| Kadota [27] | 2016 | Retrospective | TA | 50 mg | Day 3, 7, 10 (three times) →Day 1 or Day 0 (once) |
>3/4 | 36.2% (17/47) |
| Nagami [28] | 2017 | Retrospective | TA | 80 mg | Day 0 | >2/3 | 20.7% (12/58) |
| Iizuka [35] | 2017 | Retrospective | TA | 40 mg | Day 0 | >1/2 | 10.3% (3/29) |
| Nagami [36] | 2018 | Retrospective | TA | 80 mg | Day 0 | >2/3 | 16.8% (17/101) |
| Hashimoto [37] | 2019 | Retrospective | TA | 40–100 mg (2nd session: 16–50 mg) |
Day 0, 14 (two times) | >3/4 | 45.7% (16/35) |
| Oral steroid administration | |||||||
| Yamaguchi [16] | 2011 | Retrospective | PSL | 30 mg | Tapering gradually for eight weeks | >3/4 | 6.3% (1/16) |
| Yamaguchi [33] | 2013 | Retrospective | PSL | 30 mg | Tapering gradually for 6–12 weeks | >3/4 | 10% (4/40) |
| Kataoka [38] | 2015 | Retrospective | PSL | 30 mg | Tapering gradually for three weeks | >3/4 | 14.3% (2/14) |
| Modified or hybrid steroid therapy | |||||||
| Kadota [27] | 2016 | Retrospective | TA + Oral PSL | TA: 50 mg PSL: 30 mg |
TA: Day 3, 7, 10 (three times) →Day 1 or Day 0 (once) PSL: tapering gradually for eight weeks |
>3/4 | 13.3% (2/15) |
| Nagami [39] | 2016 | Retrospective | TA injection + PGA | TA: 80 mg | Day 0 | >5/6 | 25% (1/4) |
| Sakaguchi [40] | 2016 | Retrospective | TA injection + PGA | TA: 40 mg | Day 0 | >3/4 | 11.1% (1/9) |
| Nakamura [41] | 2017 | Prospective | Pulse therapy | mPSL: 500 mg (intravenous administration) |
Day 1, 2, 3 (three consecutive days) | >3/4 | 66.7% (6/9) |
| Shibagaki [42] | 2018 | Retrospective | TA filling method | TA: 80 mg | Day 1 and Day 7 and when mild stricture was found | >3/4 | 6.7% (1/15) |
| Shibagaki [43] | 2020 | Prospective | TA filling method | TA: 80 mg | Day 1 and Day 7 and when mild stricture was found | >3/4 | 5% (1/20) |
| Sakaguchi [44] | 2020 | Retrospective | TA injection + PGA | TA: 40 mg | Day 0 | >3/4 | 18.9% (7/37) |
TA, triamcinolone acetonide; PSL, prednisolone; PGA, polyglycolic acid; mPSL, methylprednisolone. The dose was shown in one session. Day 0 means immediately after ESD. * Lesion circumference (not mucosal defect circumference).