局部三氯米松（TA）注射广泛用于预防内镜下黏膜下剥离（ESD）后的狭窄形成。然而，尽管采取这种预防措施，高达45%的患者仍然会出现狭窄。因此，我们进行了一项单中心前瞻性研究，以确定食管内镜ESD和局部TA注射后狭窄的预测因素。将接受食管内镜ESD和局部TA注射的患者，以及对病变和ESD相关因素进行全面评估的患者纳入研究。进行多元分析以确定狭窄的预测因素。共有203名患者纳入分析。多元分析确定残余黏膜宽度≤5 mm（OR：29.0，P<.0001）或6-10 mm（OR：3.7，P=0.04）、放化疗史（OR：5.1，P=0.045）和颈部或上胸部食管肿瘤（OR：3.8，P=0.018）是狭窄的独立预测因素。基于预测因素的OR值，我们将患者分为高风险组（残余黏膜宽度≤5 mm或6-10 mm +另一预测因素）和低风险组（残余黏膜宽度≥10mm或6-10 mm无其他预测因素）两组。高风险组的患者（31/59例）出现狭窄的比例为52.5%，而低风险组（9/144例）的患者狭窄率为6.3%。我们确定了ESD和局部TA注射后狭窄的预测因素。对于低风险的患者，局部TA注射可以预防狭窄的形成，但对于高风险患者来说，这种方法是不足以预防狭窄的。因此，对于高风险患者，应考虑采取其他干预措施。版权所有©2023年美国胃肠镜学会。由Elsevier Inc.出版。保留所有权利。

Local triamcinolone (TA) injection is widely used to prevent stricture formation after endoscopic submucosal dissection (ESD). However, stricture develops in up to 45% of patients, despite this prophylactic measure. We therefore conducted a single-center prospective study to identify predictors of stricture after esophageal ESD and local TA injection.Patients who underwent esophageal ESD and local TA injection and who were comprehensively assessed for lesion- and ESD-related factors were included in the study. Multivariate analyses were conducted to identify the predictors of stricture.A total of 203 patients were included in the analysis. Multivariate analysis identified residual mucosal width ≤5 mm (odds ratio [OR]: 29.0, P<.0001) or 6-10 mm (OR: 3.7, P=0.04), history of chemoradiotherapy (OR: 5.1, P=0.045), and tumor in the cervical or upper thoracic esophagus (OR: 3.8, P= 0.018) as independent predictors of stricture. Based on the ORs of the predictors, we stratified patients into two groups according to stricture risk: patients in the high-risk group (residual mucosal width ≤5 mm or 6-10 mm + another predictor) had a stricture rate of 52.5% (31/59 cases), and patients in the low-risk group (residual mucosal width ≥10mm or 6-10 mm without other predictors) had a stricture rate of 6.3% (9/144 cases).We identified predictors of stricture after ESD and local TA injection. Local TA injection prevented stricture formation after ESD in low-risk patients but was not sufficient to prevent stricture in high-risk patients. Additional interventions should thus be considered in high-risk patients.Copyright © 2023 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.