Polyglycolic acid sheet and fibrin glue for preventing esophageal stricture after endoscopic submucosal dissection: a historical control study.

Abstract

There have been several reports that steroid administration is effective at preventing strictures after endoscopic submucosal dissection (ESD). However, adverse events after steroid use are of great concern. We have reported that shielding with a polyglycolic acid (PGA) sheet and fibrin glue can be useful for prevention of stricture after ESD. We conducted a retrospective analysis of efficiency of shielding with a PGA sheet and fibrin glue for prevention of esophageal stricture compared with intralesional steroid injection. ESD was performed on a total of 489 lesions in 400 patients for superficial esophageal cancer from January 2012 to July 2016. Of these, 39 lesions were enrolled in the study group (PGA sheet and fibrin glue) and 31 lesions were enrolled in the control group. The incidence of postoperative stricture at 6 weeks and the number of sessions of endoscopic balloon dilatation (EBD) required to resolve any strictures were evaluated. The post-ESD stricture rate was 9.1% in the study group (3/33 patients), which was not significantly lower than the stricture rate of 10.3% in the historical control group (3/29 patients; p = 1.00). The mean number of EBD was 0.057 ± 0.24 in the study group and 1.9 ± 5.1 in the control group, which was not significant (P = 0.95). PGA sheet and fibrin glue appear to be a promising option for the prevention of esophageal stricture similar to the effect of intralesional steroid injection.

• Authors: T Iizuka, D Kikuchi, S Hoteya, Y Kajiyama, M Kaise
• Journal: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus (Dis Esophagus) Vol. 30 Issue 11 Pg. 1-8 (Nov 01 2017) ISSN: 1442-2050 [Electronic] United States
• PMID: 28881899 (Publication Type: Evaluation Study, Journal Article)
• Copyright: © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• Fibrin Tissue Adhesive
• Steroids
• Tissue Adhesives
• Polyglycolic Acid

Topics

• Aged
• Endoscopic Mucosal Resection (adverse effects, methods)
• Esophageal Stenosis (etiology, prevention & control)
• Esophagoscopy (adverse effects, methods)
• Esophagus (pathology, surgery)
• Female
• Fibrin Tissue Adhesive (administration & dosage)
• Historically Controlled Study
• Humans
• Injections, Intralesional
• Male
• Middle Aged
• Polyglycolic Acid (administration & dosage)
• Postoperative Complications (etiology, prevention & control)
• Steroids (administration & dosage)
• Tissue Adhesives (administration & dosage)
• Treatment Outcome