title: High-density collagen patch prevents stricture after endoscopic circumferential submucosal dissection of the esophagus: a porcine model.
abstract: OBJECTIVE
  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 α-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.
authors.affiliation: Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga, Japan.
authors.forename: Shigehisa
authors.initials: S
authors.lastname: Aoki
authors.affiliation: Department of Internal Medicine & Gastrointestinal Endoscopy, Faculty of Medicine, Saga University, Saga, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Sakata
authors.affiliation: Department of Internal Medicine & Gastrointestinal Endoscopy, Faculty of Medicine, Saga University, Saga, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Shimoda
authors.affiliation: Division of Biotechnology, Institute of Agrobiological Sciences, National Agriculture and Food Research Organization, Ibaraki, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Takezawa
authors.affiliation: Division of Biotechnology, Institute of Agrobiological Sciences, National Agriculture and Food Research Organization, Ibaraki, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Oshikata-Miyazaki
authors.affiliation: Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kimura
authors.affiliation: Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga, Japan.
authors.forename: Mihoko
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Internal Medicine & Gastrointestinal Endoscopy, Faculty of Medicine, Saga University, Saga, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Iwakiri
authors.affiliation: Department of Internal Medicine & Gastrointestinal Endoscopy, Faculty of Medicine, Saga University, Saga, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
authors.affiliation: Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Toda
mesh_terms: D000818:Animals; D003094:Collagen / Q000627:therapeutic use*; D000069916:Endoscopic Mucosal Resection / Q000379:methods*; D000071041:Esophageal Mucosa / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D004940:Esophageal Stenosis / Q000517:prevention & control*; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D005260:Female; D005782:Gels; D007150:Immunohistochemistry; D008953:Models, Anatomic; D011183:Postoperative Complications / Q000517:prevention & control*; D062326:Re-Epithelialization; D013552:Swine; D014456:Ulcer; D014945:Wound Healing
chemical_list: D005782:Gels; C059821:atelocollagen; D003094:Collagen