title: A basic study of the effect of the shielding method with polyglycolic acid fabric and fibrin glue after endoscopic submucosal dissection.
abstract: Background and study aims:Recently, the shielding method with polyglycolic acid (PGA) fabric and fibrin glue (P-F method) has been reported to prevent serious complications after endoscopic submucosal dissection (ESD). However, the effectiveness and mechanism to prevent complications by this method remain unclear and the corresponding basic research has not been fully conducted.Methods and results:We examined the effectiveness and mechanism of the P-F method, using a surgical ESD model of canine stomach andin vitroexperiments. In the model experiment treated by P-F method or no treatment (control), ulcer perforation or penetration occurred only in the control group, but not in the P-F group. Microscopically, the P-F group showed less damages of the ulcer lesion than that of the control group, showing thicker granulation tissues including PGA fibers on the third day and excellent mucosal regeneration on the fourteenth day.In vitroculture experiments showed that fibroblasts proliferated at a significantly higher rate on PGA than on fibrin or a complex thereof. However, under hydrochloric acid treatment, fibroblasts were protected by fibrin, followed by the complex of both, and PGA.Conclusion:The P-F method exhibited a protective effect against gastric juice by fibrin glue to reduce tissue damages and a scaffold function of PGA fabric to induce better granulation formation at the earlier phase, resulting in excellent long-term tissue repair, on ulcer lesion following ESD, although the results were based on basic experiments.
authors.affiliation: Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan.
authors.forename: Tsujimoto
authors.initials: T
authors.lastname: Hiroyuki
authors.affiliation: Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan.
authors.forename: Yamanaka
authors.initials: Y
authors.lastname: Kohki
authors.affiliation: Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan.
authors.forename: Miyamoto
authors.initials: M
authors.lastname: Hiroe
authors.affiliation: Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan.
authors.forename: Horii
authors.initials: H
authors.lastname: Tsunehito
authors.affiliation: Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan.
authors.forename: Abe
authors.initials: A
authors.lastname: Rie
authors.affiliation: Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan.
authors.forename: Tanaka
authors.initials: T
authors.lastname: Shota
authors.affiliation: Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan.
authors.forename: Torii
authors.initials: T
authors.lastname: Hiroko
authors.affiliation: Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan.
authors.forename: Ozamoto
authors.initials: O
authors.lastname: Yuki
authors.affiliation: Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan.
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Takagi
authors.affiliation: Department of Gastroenterology, Takeda Central Hospital, Kyoto, Japan.
authors.forename: Takimoto
authors.initials: T
authors.lastname: Kengo
authors.affiliation: Department of Gastroenterology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Torii
authors.initials: T
authors.lastname: Takashi
authors.affiliation: Department of Gastroenterology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Konishi
authors.initials: K
authors.lastname: Hideyuki
authors.affiliation: QOL Institute, Gunze Ltd., Ayabe, Kyoto, Japan.
authors.forename: Takamori
authors.initials: T
authors.lastname: Hideki
authors.affiliation: Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan.
authors.forename: Hagiwara
authors.initials: H
authors.lastname: Akeo