内镜黏膜下剥离术（ESD）是目前浅表食管癌（SEC）的标准治疗方法。然而，术后粘膜缺损常导致食管狭窄。尽管类固醇的应用是有效的预防方法，但各种类固醇给药模式的有效性和安全性仍不清楚。因此，本研究旨在评估不同类固醇给药对 ESD 后 SEC 患者的疗效和安全性。在中国国家知识基础设施、万方数据库、PubMed、Embase 和 Web of Science 上检索了截至 3 月 25 日的相关研究，2024年。治疗策略分为四组：无预防作为对照（CON）、类固醇注射（SI）、口服类固醇（OS）和SI联合OS（SI OS）。通过比较荟萃分析来评估结果，包括术后食管狭窄率和狭窄后所需的内镜球囊扩张 (EBD) 次数。共纳入 25 项研究，涉及 1555 名患者。 SUCRA在预防术后食管狭窄发生率方面的排名如下：SI OS（98.9%）> OS（59.9%）> SI（41.2%）> CON（0.0%），OS（76.9%）> SI OS（62.1%） ) > SI (61.0%) > CON (0.0%) 所需的 EBD 会话数量。森林图结果表明，与非类固醇组相比，类固醇干预与较低的术后狭窄发生率和较少的 EBD 疗程相关。此外，SI OS 在预防狭窄方面优于单独的 SI 或 OS，在 EBD 疗程方面，不同类固醇给药之间没有观察到显着差异。所有干预措施的不良反应发生率均低于 10%，大多数是轻微的，停药后可缓解。这项研究表明，联合用药似乎更适合预防 ESD 后患者的食管狭窄，而类固醇可以改善狭窄的预后。然而，由于缺乏比较不同类固醇给药的大样本 RCT 研究，未来需要更多高质量的研究来证实这些发现。版权所有 © 2024 美国胃肠内窥镜学会。由爱思唯尔公司出版。保留所有权利。

Endoscopic submucosal dissection (ESD) is the standard therapy for superficial esophageal cancer (SEC) presently. However, postoperative mucosal defects often lead to esophageal stricture. Although steroid application is effective prophylaxis, the efficacy and safety of various steroid administration modes remain unclear. Thus, this study aimed to evaluate the efficacy and safety of different steroid administrations for SEC patients post-ESD.A search for relevant studies was conducted on China National Knowledge Infrastructure, Wanfang Database, PubMed, Embase, and Web of Science up to March 25, 2024. Treatment strategies were categorized into four groups: no prevention as control (CON), steroid injection (SI), oral steroids (OS), and SI combined with OS (SI+OS). Comparative meta-analysis was conducted to assess outcomes, including postoperative esophageal stricture rate and the number of endoscopic balloon dilatation (EBD) sessions required after stricture.A total of 25 studies, involving 1555 patients, were included. The SUCRA rankings were as follows: SI+OS (98.9%) > OS (59.9%) > SI (41.2%) > CON (0.0%) in preventing postoperative esophageal stricture rate, and OS (76.9%) > SI+OS (62.1%) > SI (61.0%) > CON (0.0%) in the number of EBD sessions required. Forest plot results indicated that compared with the non-steroid group, steroid interventions were associated with lower rates of postoperative stricture and fewer EBD sessions. Additionally, SI+OS was superior to SI or OS alone in preventing stricture, with no significant differences observed between different steroid administrations in terms of EBD sessions. The incidence of adverse reactions was less than 10% for all interventions, mostly mild and resolvable upon discontinuation.This study suggests that combined administration appears preferable for preventing esophageal stricture in patients post-ESD, and steroids could enhance stricture prognosis. However, due to the lack of large-sample RCT studies comparing different steroid administrations, more high-quality research is necessary to confirm these findings in the future.Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.