Safety and effectiveness of additional triamcinolone acetonide with endoscopic radial incision and cutting for benign stenosis of the lower gastrointestinal tract: A pilot study

Author:

Moroi Rintaro1ORCID,Nochioka Kotaro2,Miyata Satoshi3,Iwaki Hideya1,Chiba Hirofumi4,Nagai Hiroshi1,Shimoyama Yusuke1,Naito Takeo1,Shiga Hisashi1,Tosa Masaki5,Kakuta Yoichi1ORCID,Kayaba Shoichi4,Takahashi Seiichi5,Kinouchi Yoshitaka1,Masamune Atsushi1

Affiliation:

1. Division of Gastroenterology Tohoku University Hospital Miyagi Japan

2. Clinical Research Innovation and Education Center Tohoku University Hospital Miyagi Japan

3. Teikyo University Graduate School of Public Health Tokyo Japan

4. Division of Gastroenterology Iwate Prefectural Isawa Hospital Iwate Japan

5. Division of Gastroenterology Iwaki City Medical Center Fukushima Japan

Abstract

AbstractObjectivesRadial incision and cutting (RIC) is being investigated as an alternative endoscopic dilation method for lower intestinal tract stenosis, providing a high technical success rate and improving subjective symptoms. However, several patients develop re‐stenosis following RIC. In this pilot study, we aimed to evaluate the safety and efficacy of triamcinolone acetonide (TA) addition after RIC.MethodsRIC with TA was performed in 20 patients with lower gastrointestinal tract stenosis. We evaluated the rate of adverse events 2 months after RIC with TA. We investigated the short‐ and long‐term prognoses, as well as the improvement in subjective symptoms, using a visual analog scale.ResultsThe delayed bleeding rate after RIC was 23.8%. Endoscopic hemostasis was achieved in all patients with delayed bleeding. No perforations were observed. The cumulative re‐stenosis‐free, re‐intervention‐free, and surgery‐free rates 1 year after RIC were 52.9%, 63.7%, and 85.2%, respectively. Subjective symptoms, including abdominal pain, abdominal bloating, nausea, and dyschezia, significantly improved after RIC with TA.ConclusionAlthough additional TA administration after RIC could be safe, additional TA may not be effective on luminal patency after dilation. Further investigation is warranted.

Publisher

Wiley

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