Efficacy and Safety of Endoscopic Intralesional Triamcinolone Injection for Benign Esophageal Strictures.

Ya-Wu Zhang,Xiao-Dong Xu,You-Cheng Zhang,Zhao Liu,Xue-Ping Qi,Feng-Xian Wei

doi:10.1155/2018/7619298

Abstract

Objectives To evaluate the efficacy and safety of endoscopic intralesional triamcinolone injection (ITI) for benign esophageal strictures combined with endoscopic dilation (ED). Methods Online databases including MEDLINE, EMBASE, the Cochrane Library, and Web of Science were comprehensively searched for prospective randomized control trials (RCTs) between 1966 and March 2018. A meta-analysis was conducted according to the methods recommended by the Cochrane Collaboration. Results Six RCTs consisting of 176 patients were selected. Meta-analysis results showed that additional ITI had a significant advantage in terms of stricture rate and required ED sessions. Surgery-related and non-surgery-related strictures showed similar results. Additional ITI was not associated with significantly increased risk of complications. Conclusions Our meta-analysis showed that additional ITI therapy was supposed to be effective and safe for benign esophageal strictures as it reduced the stricture rate and required ED sessions. However, more RCTs are necessary to support these findings.

Highlights

Surgical anastomosis, radiation therapy, Schatzki’s rings, esophageal webs, corrosive injury, peptic injury, photodynamic therapy [1, 2], and endoscopic surgery can always induce benign esophageal strictures [3,4,5]
Endoscopic dilation (ED) is the first procedure adopted in clinical practice and is regarded as safe and effective, and the preferred initial treatment option irrespective of etiology [2, 7,8,9]
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Summary

Introduction

Radiation therapy, Schatzki’s rings, esophageal webs, corrosive injury, peptic injury, photodynamic therapy [1, 2], and endoscopic surgery can always induce benign esophageal strictures [3,4,5]. These injuries can induce edema, and lead to stricture formation through stimulating the proliferation of fibrotic tissue and/ or accumulation of collagen [6]. The procedure sometimes required frequent repetition due to a high risk of recurrence, and this severely influenced the patient’s quality of life. A new therapeutic method is warranted to meet clinical demand

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