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Polyglycolic acid sheet application to prevent esophageal stricture after endoscopic submucosal dissection for esophageal squamous cell carcinoma.
[esophageal squamous cell carcinoma]
Background
and
study
aim
:
Esophageal
stricture
following
endoscopic
submucosal
dissection
(
ESD
)
can
be
a
serious
complication
in
patients
with
large
mucosal
defects
.
This
preliminary
study
examined
the
efficacy
of
using
a
polyglycolic
acid
(
PGA
)
sheet
with
fibrin
glue
for
the
prevention
of
esophageal
stricture
after
ESD
.
Patients
and
methods
:
A
total
of
15
patients
were
enrolled
.
After
resection
,
PGA
sheets
were
placed
over
the
surgical
wound
.
The
size
of
the
mucosal
defect
was
estimated
by
dividing
the
circumference
of
the
esophagus
into
12
parts
of
equal
size
.
The
occurrence
of
esophageal
stricture
at
6
weeks
,
along
with
the
proportion
of
patients
who
had
PGA
sheet
remaining
in
place
1
week
and
2
weeks
after
ESD
,
and
the
occurrence
of
adverse
events
were
investigated
.
Results
:
The
size
of
mucosal
defects
in
the
15
patients
were
7
/
12
(
n
 
=
 
4
)
,
8
 
/
12
(
n
 
=
 
5
)
,
9
/
12
(
n
 
=
 
4
)
,
10
/
12
(
n
 
=
 
1
)
and
11
/
12
(
n
 
=
 
1
)
.
Esophageal
stricture
occurred
in
1
/
13
patients
(
7
.
7
 
%
;
two
patients
were
not
included
in
the
analysis
because
they
had
required
surgical
resection
during
the
follow-up
period
)
.
The
PGA
sheet
remained
at
1
week
after
ESD
in
13
/
15
patients
(
86
.
7
 
%
)
and
at
2
weeks
after
ESD
in
6
/
15
patients
(
40
 
%
)
.
No
adverse
events
were
observed
.
Conclusion
:
PGA
sheets
may
have
the
potential
to
prevent
esophageal
stricture
.
