Polyglycolic acid sheets with fibrin glue can prevent esophageal stricture after endoscopic submucosal dissection

Yoshiki Sakaguchi; Yosuke Tsuji; Satoshi Ono; Itaru Saito; Yosuke Kataoka; Yu Takahashi; Chiemi Nakayama; Satoki Shichijo; Rie Matsuda; Chihiro Minatsuki; Itsuko Asada-Hirayama; Keiko Niimi; Shinya Kodashima; Nobutake Yamamichi; Mitsuhiro Fujishiro; Kazuhiko Koike

doi:10.1055/s-0034-1390787

Endoscopy, Table of Contents

Endoscopy 2015; 47(04): 336-340
DOI: 10.1055/s-0034-1390787

Innovations and brief communications

Polyglycolic acid sheets with fibrin glue can prevent esophageal stricture after endoscopic submucosal dissection

Yoshiki Sakaguchi

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Yosuke Tsuji

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

²Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Satoshi Ono

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Itaru Saito

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Yosuke Kataoka

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Yu Takahashi

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Chiemi Nakayama

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Satoki Shichijo

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Rie Matsuda

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Chihiro Minatsuki

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Itsuko Asada-Hirayama

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Keiko Niimi

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

³Center for Epidemiology and Preventive Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Shinya Kodashima

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Nobutake Yamamichi

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Mitsuhiro Fujishiro

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

²Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

,

Kazuhiko Koike

¹Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

› Author Affiliations

Abstract

Background and study aims: Suitable techniques for the prevention of stricture formation after esophageal endoscopic submucosal dissection (ESD) are still lacking. We investigated the efficacy of polyglycolic acid (PGA) sheets with fibrin glue to prevent post-ESD stricture.

Patients and methods: We conducted a pilot study on a total of eight consecutive patients who underwent esophageal ESD that left a mucosal defect of more than three-quarters of the esophageal circumference. PGA sheets were attached to the defect with fibrin glue immediately after the completion of ESD. The primary endpoint was the incidence of post-ESD stricture. The secondary endpoints were the number of sessions of endoscopic balloon dilation (EBD) required to resolve any stricture and the rate of complications.

Results: There were no adverse events related to the use of PGA sheets and fibrin glue. Post-ESD stricture occurred in 37.5 % of the subjects and 0.8 ± 1.2 sessions of EBD were required.

Conclusion: The use of PGA sheets and fibrin glue after esophageal ESD is a novel method that radically decreases the incidence of esophageal stricture and the number of EBD sessions subsequently required.

University Hospital Medical Network Clinical Trial Registry (UMIN000011058).

Full Text

References

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