The Effectiveness Of Glucocorticoid To Prevent Esophageal Stricture After Esophagus Endoscopic Submucosal Dissection (ESD):a Meta-analysis

Objective:This meta-analysis is conducted to evaluate the effectiveness of glucocorticoid to prevent esophageal stricture after esophagus endoscopic submucosal dissection (ESD)Method:We conducted systematic search using Pubmed, Web of Science, Embase, Cochrane Library, CNKI and CBM (updated to February2015)Results:Six articles met the inclusion criteria with214cases in total, of them104cases were distributed to the intervention group and110cases were distributed to the control group.The pooled RR of esophageal stricture rate was0.20(95%CI0.10-0.39), the pooled WMD of the number of EBD sessions (preemptive glucocorticoid vs nothing to preempt)was-2.59(95%CI-3.82——1.37), the pooled WMD of the number of EBD sessions(preemptive glucocorticoid vs preemptive EBD) was-15.74(95%CI-20.30——11.19). Procedure-related bleeding during the first15days was observed less in the gel application group than local steroid injection group (0vs0.46, P=0.02).The mean number of endoscopic balloon dilatation procedures performed for treating dysphagia that appeared on or after POD20was significantly less in the the gel application group than local steroid injection group (1.6vs4.27, P=0.011).Conclusion:Glucocorticoid can prevent esophageal stricture after esophagus endoscopic submucosal dissection (ESD). The gel application is better than local steroid injection group...