局部曲安奈德注射预防浅表性咽部肿瘤内镜黏膜下剥离术后咽部畸形
Local triamcinolone acetonide injection for the prevention of pharyngeal deformity following endoscopic submucosal dissection of superficial pharyngeal neoplasms.
文献信息
| PMID | 42763380 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yugo Suzuki |
| 作者单位 | Department of Gastroenterology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan. yugo-suzuki@nms.ac.jp. |
| 期刊 | Esophagus : official journal of the Japan Esophageal Society |
| SCI 分区 | Q1 |
| IF | 3.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 对下咽部肿瘤行内镜黏膜下剥离术（ESD）后，广泛黏膜切除可导致瘢痕挛缩和咽部畸形，可能增加吸入性肺炎的风险。本研究旨在评估局部曲安奈德（TA）注射预防ESD术后咽部畸形的有效性和安全性。
方法： 这项回顾性队列研究纳入2011年至2026年间接受ESD治疗下咽部肿瘤的388例患者。患者分为ESD后接受局部TA注射组（TA组，n=65）和未接受组（对照组，n=323）。根据内镜表现将ESD术后咽部畸形分为四级。根据黏膜缺损范围将梨状窝分为三个亚区。
结果： TA组的畸形严重程度显著低于对照组，且≥2级畸形更少（均p<.001）。仅在梨状窝中观察到显著的预防效果（均p<.001）。在涉及多个梨状窝亚区的黏膜缺损中，对于涉及两个亚区（分别p<.001和p=.046）和三个亚区（均p<.001）的黏膜缺损，TA组的这两项结局均显著更低。倾向性评分匹配后也观察到类似结果。未观察到与TA注射相关的不良事件。
结论： 局部TA注射可能是预防ESD术后咽部畸形的有效且安全的策略，特别是在涉及多个梨状窝亚区的黏膜缺损中。
英文摘要
BACKGROUND: Extensive mucosal resection following endoscopic submucosal dissection (ESD) for hypopharyngeal neoplasms can result in scar contracture and pharyngeal deformity, potentially increasing the risk of aspiration pneumonia. This study aimed to evaluate the efficacy and safety of local triamcinolone acetonide (TA) injection for preventing post-ESD pharyngeal deformity.
METHODS: This retrospective cohort study included 388 patients who underwent ESD for hypopharyngeal neoplasms between 2011 and 2026. Patients were divided into those who received local TA injection after ESD (TA group, n = 65) and those who did not (control group, n = 323). Post-ESD pharyngeal deformity was classified into four grades based on endoscopic findings. The piriform sinus was subdivided into three subfields according to the extent of the mucosal defect.
RESULTS: The TA group had a significantly lower deformity severity and fewer grade ≥ 2 deformities than the control group (both p < .001). Significant preventive effects were observed only in the piriform sinus (both p < .001). Among mucosal defects involving multiple piriform sinus subfields, both outcomes were significantly lower in the TA group for mucosal defects involving two (p < .001 and p = .046, respectively) and three (both p < .001) subfields. Similar findings were observed after propensity score matching. No adverse events related to TA injection were observed.
CONCLUSIONS: Local TA injection may be an effective and safe strategy for preventing post-ESD pharyngeal deformity, particularly in mucosal defects involving multiple piriform sinus subfields.