Related Experiment Video
Updated: Jan 15, 2026
ADSC-sheet Transplantation to Prevent Stricture after Extended Esophageal Endoscopic Submucosal Dissection
Published on: February 10, 2017
Pharmacological therapy for preventing esophageal stricture after endoscopic submucosal dissection: a systematic
Yuxin Ma1, Liang Zhu2, Shutao Chen2
1The Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
Objective:
Endoscopic submucosal dissection (ESD) is a commonly used minimally invasive technique for treating early esophageal tumors. Postoperative esophageal stricture is a frequent complication. This study aimed to compare the efficacy of existing pharmacological therapies in preventing esophageal stricture after ESD and to determine the most effective regimen to inform clinical practice.
Methods:
A systematic literature search of the Cochrane Library, Embase, PubMed, and Web of Science databases was performed from inception to 20 March 2025. The main search terms included "endoscopic mucosal resection" and "ESD." The main outcome assessed was the incidence of esophageal stricture, while the secondary outcome involved the number of endoscopic balloon dilatation (EBD) sessions needed to manage severe postoperative strictures. This network meta-analysis was conducted using random-effects models. Mean differences (MDs) and relative risks (RRs) were estimated along with their 95% credible intervals (CrIs). Interventions were ranked based on the surface under the cumulative ranking curve (SUCRA) values. All statistical analyses were conducted using R software (version 4.5.0).
Results:
Thirty-one studies involving 3085 patients who underwent ESD were included. In terms of esophageal stricture incidence, oral hydrocortisone sodium succinate combined with aluminum phosphate gel demonstrated the greatest reduction in the risk of stricture compared with standard care (RR = 0.075, 95% CrI: 0.017, 0.24; SUCRA = 95.21%). Regarding the number of EBD sessions, the combination of polyglycolic acid (PGA) sheet plus fibrin glue resulted in the fewest sessions compared with standard care (MD = - 6.4, 95% CrI: - 8.4, - 4.3; SUCRA = 95.82%).
Conclusions:
In patients undergoing ESD, oral hydrocortisone sodium succinate combined with aluminum phosphate gel was the most effective intervention for reducing the incidence of postoperative esophageal stricture. The combination of PGA sheet plus fibrin glue was most effective in minimizing the number of EBD sessions required.
More Related Videos
Related Concept Videos
01:26Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
01:30Esophageal Strictures-I: Introduction
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
01:29Gastroesophageal Reflux Disease II: Clinical Features and Management
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
01:21Barrett Esophagus-II: Clinical Manifestations and Management
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
01:26Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...