title: Polyglycolic acid sheet application to prevent esophageal stricture after endoscopic submucosal dissection for esophageal squamous cell carcinoma.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  PGA sheets may have the potential to prevent esophageal stricture.
authors.affiliation: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Iizuka
authors.affiliation: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kikuchi
authors.affiliation: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yamada
authors.affiliation: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Hoteya
authors.affiliation: Department of Upper Gastrointestinal Surgery, Juntendo University, Tokyo, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kajiyama
authors.affiliation: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Kaise
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004210:Dissection / Q000009:adverse effects* / Q000379:methods; D004938:Esophageal Neoplasms / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology / Q000517:prevention & control*; D004945:Esophagoscopy; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000009:adverse effects / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000601:surgery; D011100:Polyglycolic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D014014:Tissue Adhesives / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D011100:Polyglycolic Acid