Endoscopic dilatation combined with submucosal injection of triamcinolone acetonide for benign esophageal stricture

Abstract

Objective To explore the safety and efficacy of endoscopic dilatation combined with submucosal injection of tfiamcinolone acetonide in treatment of benign esophageal stricture. Methods The patients of benign esophageal stricture proved by biopsy were randomly divided into three groups. Group A were treated by expansion only, group B were injected with triamcinolone acetonide submucosal combined with expansion, and we treated group C by another injection a week later on the basis of treatment in group B. A 12 months＇ follow-up was conducted, the dysphagia score, the cure rate. time to sustained symptom re- lief, re-expansion time interval and adverse reactions were recorded. Results Some patients experienced chest pain and regurgitation after the procedure and all improved by corresponding managements. No compli- cations including massive bleeding, infection, perforation or local tissue atrophy were observed. The dysphagia scores in 3 groups after the procedure were all improved （ P 〈 0. 05 ） , and no significant difference was noticed between 3 groups （ P 〉 0. 05 ）. At the end of the follow-up, the duration of dysphagia remission and the interval between 2 consecutive dilatation in Group A were 14.4 ± 3.2 weeks and 18.2 ± 3.7 weeks, respectively, which were significant shorter than those in Group B （19. 3 ± 3.9 weeks and 24. 6 ± 4. 2 weeks, respectively） and those in Group C （20. 2 ± 4. 2 weeks and 26. 1 ± 4. 5 weeks, respectively） , while there was no difference between Groups B and C. The cure rate in Group C （43.5% , 10/23 ） was significantlyhigher than that of Group A （29.2%, 7/24） or Group B （27.3% , 6/22） , while there was no difference between Groups A and B. Conclusion Endoscopic dilatation combined with submucosal injection of triamcinolone acetonide is safe and may improve the symptoms of dysphagia and delay the re-stenosis for patients with benign esophageal stricture, meanwhile, multi-frequency treatment may improve the cure rate. Key words: Triamcinolone acetonide; Esophageal stricture; Submucosal injection