METHODS: We retrospectively gathered clinical data from a single center on patients with early esophageal cancer who underwent ESD. Patients were categorized into 2 groups: the steroid group (receiving only oral prednisolone) and the steroid+nasogastric tube retention (NGT) group. We analyzed the incidence of esophageal stricture and identified risk factors for its development.
RESULTS: The study included 79 patients, with 30 in the steroid group and 49 in the steroid+NGT group. The incidence of stricture was significantly higher in the steroid group (9/30, 30.0%) compared to the steroid+NGT group (3/49, 6.1%) (P = .004). Notably, we observed a significant difference in the stricture rates between the 2 groups, particularly in patients with a complete circumferential defect (100% and 16.7%) (P = .015). Multivariate logistic regression analysis revealed that a full circumferential defect of the esophageal mucosa (OR 12.501; 95% CI 1.907, 81.047; P = .008), invasion depth beyond the lamina propria (OR 5.635; 95% CI 1.039, 30.559; P = .045), and the absence of NGT retention (OR 12.896; 95% CI 2.099, 79.219; P = .006) were independent risk factors predicting the development of a stricture.
CONCLUSIONS: The combination of steroids with NGT retention is more effective than using oral steroids alone in preventing esophageal stricture after extensive ESD.
方法:我们回顾性收集了一个单中心的早期食管癌患者接受ESD治疗的临床数据。患者分为2组:类固醇组(仅接受口服泼尼松龙)和类固醇鼻胃管留置(NGT)组。我们分析了食管狭窄的发生率,并确定了其发展的危险因素。
结果:该研究包括79名患者,类固醇组30例,类固醇+NGT组49例。类固醇组(9/30,30.0%)的狭窄发生率明显高于类固醇NGT组(3/49,6.1%)(P=.004)。值得注意的是,我们观察到两组之间的狭窄率存在显着差异,特别是在具有完全环状缺损的患者中(100%和16.7%)(P=0.015)。多因素logistic回归分析显示食管黏膜全环缺损(OR12.501;95%CI1.907,81.047;P=.008),固有层以外的侵入深度(OR5.635;95%CI1.039,30.559;P=.045),无NGT保留(OR12.896;95%CI2.099,79.219;P=.006)是预测狭窄发展的独立危险因素。
结论:类固醇联合NGT滞留比单独使用口服类固醇更有效地预防广泛ESD后的食管狭窄。