stricture after esophageal endoscopic submucosal dissection

A new device (micro hole balloon) enabling safer, more efficient local triamcinolone(TA) injection in less time.

【Method】This study included 85 patients who underwent endoscopic submucosal dissection (ESD) for esophageal cancer with local TA injection at a single high-volume center between January 2021 and August 2025. Exclusion criteria were as follows: history of esophageal surgery (5 cases), additional surgical resection after endoscopic treatment (4 cases), residual recurrence after photodynamic therapy, ESD, and chemoradiotherapy (6 cases), and incomplete follow-up(3 cases). A comparative analysis was performed between 45 cases treated with a local injection needle from January 2021 to February 2024 and 22 cases treated with a micro-hole balloon from March 2024 to August 2025. 【Result】Lesion localization was in the cervical or upper thoracic esophagus in 17 cases (25.6%). Circumference of the post-resection ulcer was greater than or equal to 3/4 in 57 cases (85.1%), and circumferential resection were performed in 8 cases (11.9%). The median tumor size was 52 mm. Muscle layer injury was observed in 21 cases (31.3%) during ESD. Oral steroid administration was combined in 39 cases (58.2%), and stenosis was observed in 14 cases (20.9%). No significant differences were observed between the needle injection and balloon injection groups in patient characteristics such as tumor location (localized/circumferential), tumor length, malignancy grade, or muscle layer injury. Oral steroid administration tended to be less frequent in the balloon group, but this difference was not statistically significant (64.4% vs. 45.5%: P=0.189). Procedure time was significantly shorter in the balloon group (310 sec vs. 69 sec: P<0.01). Both the stenosis rate (28.9% vs. 4.5%: P=0.025) and the number of balloon dilation required to achieve stenosis (9 vs. 4: P=0.012) were significantly lower in the balloon group. No complication was observed in TA injection in the balloon group. 

The micro hole balloon is considered a highly useful device, enabling safe, efficient, and rapid administration of TA.