The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform
Kazuhiko Nakao - One of the best experts on this subject based on the ideXlab platform.
-
management of Esophageal Stricture after complete circular endoscopic submucosal dissection for superficial Esophageal squamous cell carcinoma
BMC Gastroenterology, 2011Co-Authors: Hajime Isomoto, Naoyuki Yamaguchi, Toshiyuki Nakayama, Tomayoshi Hayashi, Hitoshi Nishiyama, Ken Ohnita, Fuminao Takeshima, Saburo Shikuwa, Shigeru Kohno, Kazuhiko NakaoAbstract:Background Endoscopic submucosal dissection (ESD) permits removal of Esophageal epithelial neoplasms en bloc, but is associated with Esophageal stenosis, particularly when ESD involves the entire circumference of the Esophageal lumen. We examined the effectiveness of systemic steroid administration for control of postprocedural Esophageal Stricture after complete circular ESD.
Chittinad Havanond - One of the best experts on this subject based on the ideXlab platform.
-
A prospective randomized controlled trial of omeprazole for preventing Esophageal Stricture in grade 2b and 3a corrosive Esophageal injuries
Surgical Endoscopy, 2020Co-Authors: Prasit Mahawongkajit, Prakitpunthu Tomtitchong, Nuttorn Boochangkool, Chatchai Mingmalairak, Surajit Awsakulsutthi, Chittinad HavanondAbstract:Objectives Esophageal Stricture is a significant complication of grade 2b and 3a Esophageal injuries and causes much patient suffering. Preventing Strictures would be beneficial to patients but there are currently no proven effective drugs. This study aimed to evaluate the effect of omeprazole for preventing Esophageal Stricture in adults with grade 2b and 3a corrosive Esophageal injuries. Methods This study was an open single-center prospective randomized controlled trial that took place from April 2018 to January 2020. Patients were randomized to standard treatment or 80 mg/day intravenously × 3 days followed by 40 mg/day orally for 4 weeks. They were endoscoped at baseline and 4 weeks post discharge. Strictures were confirmed radiologically. Results 20 patients were enrolled: 15 with grade 2b and five with grade 3a injuries. Standard care and omeprazole groups numbered 10 each. At 1 month, seven and two patients developed Strictures in the standard and omeprazole groups, respectively, p = 0.024 , for a risk reduction of 71.4%. Conclusions Omeprazole reduced the risk of short-term developing Esophageal Strictures following grade 2b and 3a corrosive Esophageal injuries. Larger studies are needed to reconfirm this finding. Thai Clinical Trials Registry (TCTR) number TCTR20190504001
-
Risk Factors for Esophageal Stricture in Grade 2b and 3a Corrosive Esophageal Injuries
Journal of Gastrointestinal Surgery, 2018Co-Authors: Prasit Mahawongkajit, Prakitpunthu Tomtitchong, Nuttorn Boochangkool, Palin Limpavitayaporn, Amonpon Kanlerd, Chatchai Mingmalairak, Surajit Awsakulsutthi, Chittinad HavanondAbstract:Background and Purpose Publications document the risk of developing Esophageal Stricture as a sequential complication of Esophageal injury grades 2b and 3a. Although there are studies describing the risk factors of post-corrosive Stricture, there is limited literature on these factors. The aim of this study was to evaluate the different factors with post-corrosive Esophageal Stricture and non-Stricture groups in endoscopic grades 2b and 3a of corrosive Esophageal injuries. Methods Data were retrospectively analyzed in the patients with Esophageal injury grades 2b and 3a between January 2011 and December 2017. Results One hundred ninety-six corrosive ingestion patients were admitted with 32 patients (15.8%) in grade 2b and 12 patients (6.1%) in grade 3a and Stricture was developed in 19 patients (61.3%) with grade 2b and in 10 patients (83.3%) with grade 3a. The patients’ height of the non-Stricture group was greater than that of Stricture groups (2b Stricture group, 1.58 ± 0.08 m; 2b non-Stricture group, 1.66 ± 0.07 m; p < 0.004; 3a Stricture group, 1.52 ± 0.09 m; 3a non-Stricture group, 1.71 ± 0.02 m; p < 0.001). Omeprazole was more commonly used in the non-Stricture than Stricture group (26.3% in the 2b Stricture group, 69.2% in the 2b non-Stricture group, p = 0.017; 50% in the 3a Stricture group, 100% in the 3a non-Stricture group, 1.71 ± 0.02 m, p = 0.015). Conclusions The height of patients may help to predict the risks and the prescription of omeprazole may help to minimize the risks of 2b and 3a post-corrosive Esophageal Stricture.
Mitsuru Kaise - One of the best experts on this subject based on the ideXlab platform.
-
polyglycolic acid sheet application to prevent Esophageal Stricture after endoscopic submucosal dissection for Esophageal squamous cell carcinoma
Endoscopy, 2014Co-Authors: Toshiro Iizuka, Daisuke Kikuchi, Akihiro Yamada, Shu Hoteya, Yoshiaki Kajiyama, Mitsuru KaiseAbstract:Background and study aim: Esophageal Stricture following endoscopic submucosal dissection (ESD) can be a serious complication in patients with large mucosal defects. This preliminary study examined the efficacy of using a polyglycolic acid (PGA) sheet with fibrin glue for the prevention of Esophageal Stricture after ESD. Patients and methods: A total of 15 patients were enrolled. After resection, PGA sheets were placed over the surgical wound. The size of the mucosal defect was estimated by dividing the circumference of the esophagus into 12 parts of equal size. The occurrence of Esophageal Stricture at 6 weeks, along with the proportion of patients who had PGA sheet remaining in place 1 week and 2 weeks after ESD, and the occurrence of adverse events were investigated. Results: The size of mucosal defects in the 15 patients were 7/12 (n = 4), 8 /12 (n = 5), 9/12 (n = 4), 10/12 (n = 1) and 11/12 (n = 1). Esophageal Stricture occurred in 1/13 patients (7.7 %; two patients were not included in the analysis because they had required surgical resection during the follow-up period). The PGA sheet remained at 1 week after ESD in 13/15 patients (86.7 %) and at 2 weeks after ESD in 6/15 patients (40 %). No adverse events were observed. Conclusion: PGA sheets may have the potential to prevent Esophageal Stricture.
Koichi Taira - One of the best experts on this subject based on the ideXlab platform.
-
prediction of Esophageal Stricture in patients given locoregional triamcinolone injections immediately after endoscopic submucosal dissection
Digestive Endoscopy, 2018Co-Authors: Yasuaki Nagami, Masaki Ominami, Masatsugu Shiba, Taishi Sakai, Shusei Fukunaga, Satoshi Sugimori, Koji Otani, Shuhei Hosomi, Fumio Tanaka, Koichi TairaAbstract:Background and Aim Esophageal endoscopic submucosal dissection (ESD) to resect widespread lesions has increased the incidence of Strictures, and some patients develop Strictures despite receiving prophylactic locoregional triamcinolone injections. The present study evaluated the predictive factors for Esophageal Stricture formation in patients given prophylactic triamcinolone injections after ESD. Methods This was a retrospective observational study. Of 552 consecutive patients who underwent ESD, those who received prophylactic triamcinolone injections immediately after ESD were enrolled. Primary outcome was predictive factors for Esophageal Stricture formation in patients given prophylactic triamcinolone injections. Results We evaluated 101 en bloc resections involving 144 lesions in 96 patients. Strictures occurred following 17 (16.8%) resections. Wider circumferential mucosal defect (odds ratio [OR] 2.42, 95% confidence interval [CI]: 1.01–5.80; P = 0.048) was an independent predictive factor for Stricture development. Cut-off value associated with Stricture formation was five-sixths of the circumferential mucosal defect. Propensity analysis determined that frequency of Esophageal Strictures increased in patients with circumferential mucosal defects of more than five-sixths compared with those less than five-sixths (OR = 5.70, 95% CI: 1.61–20.18; P = 0.007). Conclusion Resections involving circumferential mucosal defects of more than five-sixths increased the likelihood of Stricture formation in patients given prophylactic locoregional triamcinolone injections after Esophageal ESD.
Tomoyuki Nagai - One of the best experts on this subject based on the ideXlab platform.
-
clinical analysis of Esophageal Stricture in patients treated with intralesional triamcinolone injection after endoscopic submucosal dissection for superficial Esophageal cancer
Oncology, 2017Co-Authors: Kazuki Okamoto, Shigenaga Matsui, Tomohiro Watanabe, Yutaka Asakuma, Yoriaki Komeda, Ayana Okamoto, Ishikawa Rei, Masashi Kono, Mitsunari Yamada, Tomoyuki NagaiAbstract:Introduction Endoscopic submucosal dissection (ESD) has been widely used in the resection of superficial Esophageal cancers. Since its use has been extended to cases involving large Esophageal tumors occupying nearly the whole or the whole circumference of the lumen, the occurrence of Esophageal Stricture has increased. Although endoscopic injection of triamcinolone (TA) is widely used for the prevention of postoperative Stricture, a significant number of patients still develop Stricture after TA injection therapy. Methods We performed a retrospective study to identify the clinical parameters that predispose post-ESD patients to Esophageal Stricture after TA injection therapy. Results A total of 207 patients who were diagnosed with superficial Esophageal cancer and subsequently underwent ESD were enrolled in this study. Among these patients, 53 patients and 57 lesions bearing mucosal defects covering greater than two-thirds of the Esophageal circumference after ESD were treated with TA injection therapy. The rate of Esophageal Stricture was found to be highest in cases involving mucosal defects that covered more than seven-eighths of the circumference. Conclusion Endoscopic TA injection is not sufficient for preventing Esophageal Stricture in patients bearing mucosal defects covering more than seven-eighths of the Esophageal circumference after ESD.