title: Development of novel treatment with a bioabsorbable esophageal patch for benign esophageal stricture.
abstract: Using a large animal model, we examined whether circumferential stricture after esophageal endoscopic submucosal dissection (ESD) can be treated by grafting a bioabsorbable esophageal patch. Circumferential ESD was performed on the thoracic esophagus in pigs (n = 6) to create a stricture, for which one of the following interventions was performed: (1) the stricture site was longitudinally incised, and an artificial esophageal wall (AEW) was grafted after placing a bioabsorbable stent (AEW patch group, n = 3); (2) endoscopic balloon dilation (EBD) was performed every other week after stricture development (EBD group, n = 3). In both groups, esophageal fluoroscopy was performed 8 weeks after the interventions, and the esophagus was excised for histological examination of the patched site. In the AEW patch group, esophageal fluoroscopy revealed favorable passage through the patched site. Histologically, the mucosal epithelium and lamina propria had regenerated as in the normal area. In the EBD group, the circumferential stricture site showed marked thickening, and there were hypertrophic scars associated with epithelial defects on the luminal surface. Histologically, defects of the mucosal epithelium and full-thickness proliferation of connective tissue were observed. AEW patch grafting was suggested to be a potentially novel treatment strategy for post-ESD esophageal circumferential stricture.
authors.affiliation: Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Takase
authors.affiliation: Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Aikawa
authors.affiliation: Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Okada
authors.affiliation: Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Sato
authors.affiliation: Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nonaka
authors.affiliation: Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yamaguchi
authors.affiliation: Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Sakuramoto
authors.affiliation: Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Koyama
authors.affiliation: Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Miyazawa
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D002404:Catheterization / Q000295:instrumentation / Q000379:methods; D017439:Cicatrix, Hypertrophic; D004195:Disease Models, Animal; D004210:Dissection / Q000379:methods; D004848:Epithelium / Q000502:physiology / Q000601:surgery; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D004945:Esophagoscopy / Q000295:instrumentation / Q000379:methods*; D004947:Esophagus / Q000000981:diagnostic imaging / Q000473:pathology / Q000637:transplantation*; D005471:Fluoroscopy; D009092:Mucous Membrane / Q000502:physiology / Q000601:surgery; D012038:Regeneration; D015607:Stents; D013552:Swine; D016896:Treatment Outcome
keywords: balloon dilation; benign esophageal stricture; bioabsorbable polymer; endoscopic submucosal dissection; esophageal stent