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Copyright ©2014 Baishideng Publishing Group Inc.
World J Gastroenterol. Nov 7, 2014; 20(41): 15098-15109
Published online Nov 7, 2014. doi: 10.3748/wjg.v20.i41.15098
Table 1 Anti-inflammatory drugs for the prevention of esophageal strictures after endoscopic submucosal dissection
ActionAdministrationAdvantagesDisadvantages and limitations
Clinical study
CorticosteroidsSteroidalOral intakeStrongly inhibits the infiltration of inflammatory cells, the hyperplasia associated with granulation, and the fibrosis of the remaining submucosal layerGeneral side effects (severe infection, peptic ulcer, hyperglycemia, psychiatric symptoms, and osteoporosis)
Delayed wound healing
Triamcinolone acetonideSteroidalLocal injectionInhibits the infiltration of inflammatory cells, the hyperplasia associated with granulation, and the fibrosis of the remaining submucosal layerRisk of ulcer formation due to accidental injection into the muscularis
Delayed wound healing
Pre-clinical study
MMCInhibition of DNA synthesisLocal injectionInhibits the proliferation and activation of fibroblastsAn effect has not been shown for the prevention of esophageal strictures, although MMC improves recurrent dysphagia or restenosis after the dilatation of esophageal strictures
The risks of perforation and secondary malignancy
N-acetylcysteineAntioxidant moleculeOral intakeAntifibrotic effect without the inhibition of wound healingInsufficient effect in an animal model of severe esophageal stricture