2018 Volume 60 Issue 10 Pages 2259-2274
Endoscopic submucosal dissection (ESD) has become widespread, enabling endoscopic resection of a wide range of esophageal cancers. On the other hand, it has become clear that the risk of stricture after esophageal ESD is high when the circumferential mucosal defect after ESD exceeds 3/4 of the esophageal circumference. Currently, steroid injection therapy and oral steroid therapy are mainstream treatments for prophylaxis against esophageal ESD stricture. However, it is not clear whether steroid injection therapy and oral steroid therapy are useful and safe. Therefore, the Japanese Clinical Oncology Research Group is performing a randomized phase Ⅲ trial on the safety and efficacy of steroid injection therapy and oral steroid therapy as two methods of prophylaxis against esophageal ESD stricture. We also hope for the development of a tissue shielding method such as a polyglycolic acid sheet and autologous cell sheet transplantation as regenerative medicine.
