Triamcinolone Acetonide Knife-Tracing Injection for Prevention of Esophageal Stricture After Endoscopic Submucosal Dissection

Background and Aims Postoperative stricture is a common problem after extensive esophageal endoscopic submucosal dissection (ESD). Local triamcinolone acetonide (TA) injection is widely used for stricture prevention, but conventional needle-based injection requires repeated punctures and careful depth control. We developed the Triamcinolone Acetonide Knife-Tracing Injection (TAK-Trace) technique for linear TA delivery after esophageal ESD. Methods After completion of ESD and confirmation of hemostasis, TA was delivered using the same ESD knife without device exchange. The retracted knife was gently moved along the ulcer surface while TA was continuously delivered into the superficial submucosal layer. Results We present 2 representative cases from our initial clinical experience. Both cases involved extensive mucosal defects after esophageal ESD. In both cases, TA was successfully delivered along the post-ESD mucosal defect, and no postoperative stricture developed during follow-up. Conclusions The TAK-Trace technique may provide a practical option for linear TA delivery after extensive esophageal ESD.