Intralesional steroid is beneficial in benign refractory esophageal strictures: A meta-analysis

L. Szapáry, Benedek Tinusz, Nelli Farkas, Katalin Márta, Lajos Szakó, Ágnes Meczker, Roland Hágendorn, Judit Bajor, A. Vincze, Zoltán Gyöngyi, Alexandra Mikó, Dezso Csupor, Péter Hegyi, Bálint Eross

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Abstract

AIM To analyze the effect of intralesional steroid injections in addition to endoscopic dilation of benign refractory METHODS A comprehensive search was performed in three databases from inception to 10 April 2017 to identify trials, comparing the efficacy of endoscopic dilation to dilation combined with intralesional steroid injections. Following the data extraction, meta-analytical calculations were performed on measures of outcome by the randomeffects method of DerSimonian and Laird. Heterogeneity of the studies was tested by Cochrane's Q and I2 statistics. Risk of quality and bias was assessed by the Newcastle Ottawa Scale and JADAD assessment tools. RESULTS Eleven articles were identified suitable for analyses, involving 343 patients, 235 cases and 229 controls in total. Four studies used crossover design with 121 subjects enrolled. The periodic dilation index (PDI) was comparable in 4 studies, where the pooled result showed a significant improvement of PDI in the steroid group (MD: -1.12 dilation/month, 95%CI: -1.99 to -0.25 P = 0.012; I2 = 74.4%). The total number of repeat dilations (TNRD) was comparable in 5 studies and showed a non-significant decrease (MD: -1.17, 95%CI: -0.24-0.05, P = 0.057; I2 = 0), while the dysphagia score (DS) was comparable in 5 studies and did not improve (SMD: 0.35, 95%CI: -0.38, 1.08, P = 0.351; I2 = 83.98%) after intralesional steroid injection. CONCLUSION Intralesional steroid injection increases the time between endoscopic dilations of benign refractory esophageal strictures. However, its potential role needs further research.

Original languageEnglish
Pages (from-to)2311-2319
Number of pages9
JournalWorld Journal of Gastroenterology
Volume24
Issue number21
DOIs
Publication statusPublished - Jun 7 2018

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Keywords

  • Benign refractory esophageal stricture
  • Dilation
  • Intralesional steroid
  • Meta-analysis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Szapáry, L., Tinusz, B., Farkas, N., Márta, K., Szakó, L., Meczker, Á., Hágendorn, R., Bajor, J., Vincze, A., Gyöngyi, Z., Mikó, A., Csupor, D., Hegyi, P., & Eross, B. (2018). Intralesional steroid is beneficial in benign refractory esophageal strictures: A meta-analysis. World Journal of Gastroenterology, 24(21), 2311-2319. https://doi.org/10.3748/wjg.v24.i21.2311