High-density collagen patch prevents stricture after endoscopic circumferential submucosal dissection of the esophagus: a porcine model
High-density collagen patch prevents stricture after endoscopic circumferential submucosal dissection of the esophagus: a porcine model
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DOI：
10.1016/j.gie.2016.10.012
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发表时间：
2017-05-01
影响因子：
7.7
通讯作者：
Toda, Shuji
中科院分区：
文献类型：
--
作者：
Aoki, Shigehisa;Sakata, Yasuhisa;Toda, Shuji
背景和目的：内镜粘膜下剥离术（ESD）广泛切除食管粘膜经常引起管腔狭窄。本研究的目的是确定高密度胶原蛋白补丁预防食管狭窄广泛ESD.Methods的有效性：6只猪进行了全身麻醉下的环食管ESD。在3只猪中，人工溃疡被2个胶原蛋白贴片覆盖。结果：两种胶原补片均在普通内镜和器械下固定在溃疡表面。在第14天，与对照组相比，胶原贴片治疗组在伤口区域的口腔侧和肛门侧均显示出显著更好的通畅率。胶原补片治疗后，创面黏膜上皮再生率明显提高，黏膜炎症和纤维化程度明显减轻。细胞阳性的α-平滑肌肌动蛋白的频率显着降低胶原补丁治疗组与control group.Conclusions相比：我们已经建立了一个高密度的胶原设备，可以减少食管狭窄与广泛的ESD。这种易于操作的装置在ESD治疗浅表食管癌期间将是有用的。
Background and Aims: Extensive excision of the esophageal mucosa by endoscopic submucosal dissection (ESD) frequently evokes a luminal stricture. This study aimed to determine the efficacy of a high-density collagen patch for the prevention of esophageal stricture in extensive ESD.Methods: Six pigs underwent circumferential esophageal ESD under general anesthesia. In 3 pigs, artificial ulcers were covered by 2 collagen patches. The other 3 pigs underwent circumferential ESD only.Results: The 2 collagen patches were settled onto the ulcer surface using a general endoscope and instruments. The collagen patch-treated group showed significantly better patency rates on both the oral and anal sides of the wound area compared with the control group at day 14. The mucosal re-epithelization ratio was significantly promoted, and the extent of mucosal inflammation and fibrosis was significantly decreased with the collagen patch treatment in the wound area. The frequency of cells positive alpha-smooth muscle actin was significantly reduced in the collagen patch-treated group compared with the control group.Conclusions: We have established a high-density collagen device that can reduce the esophageal stricture associated with extensive ESD. This easy-to-handle device would be useful during superficial esophageal cancer treatment by ESD.