title: Self-assembling peptide matrix for the prevention of esophageal stricture after endoscopic resection: a randomized controlled trial in a porcine model.
abstract: Esophageal stricture formation after extensive endoscopic resection remains a major limitation of endoscopic therapy for early esophageal neoplasia. This study assessed a recently developed self-assembling peptide (SAP) matrix as a wound dressing after endoscopic resection for the prevention of esophageal stricture. Ten pigs were randomly assigned to the SAP or the control group after undergoing a 5-cm-long circumferential endoscopic submucosal dissection of the lower esophagus. Esophageal diameter on endoscopy and esophagogram, weight variation, and histological measurements of fibrosis, granulation tissue, and neoepithelium were assessed in each animal. The rate of esophageal stricture at day 14 was 40% in the SAP-treated group versus 100% in the control group (P = 0.2). Median interquartile range (IQR) esophageal diameter at day 14 was 8 mm (2.5-9) in the SAP-treated group versus 4 mm (3-4) in the control group (P = 0.13). The median (IQR) stricture indexes on esophagograms at day 14 were 0.32 (0.14-0.48) and 0.26 (0.14-0.33) in the SAP-treated and control groups, respectively (P = 0.42). Median (IQR) weight variation during the study was +0.2 (-7.4; +1.8) and -3.8 (-5.4; +0.6) in the SAP-treated and control groups, respectively (P = 0.9). Fibrosis, granulation tissue, and neoepithelium were not significantly different between the groups. The application of SAP matrix on esophageal wounds after a circumferential endoscopic submucosal dissection delayed the onset of esophageal stricture in a porcine model.
authors.affiliation: Department of Gastroenterology, Cochin Hospital, Paris, France.|Faculté Paris Descartes, Paris, France.|Inserm Unit 1016, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Barret
authors.affiliation: Faculté Paris Descartes, Paris, France.|Inserm Unit 1016, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Bordaçahar
authors.affiliation: Faculté Paris Descartes, Paris, France.|Department of Pathology, Cochin Hospital, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Beuvon
authors.affiliation: Faculté Paris Descartes, Paris, France.|Department of Pathology, Cochin Hospital, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Terris
authors.affiliation: Department of Gastroenterology, Cochin Hospital, Paris, France.|Faculté Paris Descartes, Paris, France.|Inserm Unit 1016, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Camus
authors.affiliation: Department of Gastroenterology, Cochin Hospital, Paris, France.|Faculté Paris Descartes, Paris, France.|Inserm Unit 1016, Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Coriat
authors.affiliation: Department of Gastroenterology, Cochin Hospital, Paris, France.|Faculté Paris Descartes, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Chaussade
authors.affiliation: Faculté Paris Descartes, Paris, France.|Inserm Unit 1016, Paris, France.|Department of Immunology, Cochin Hospital, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Batteux
authors.affiliation: Department of Gastroenterology, Cochin Hospital, Paris, France.|Faculté Paris Descartes, Paris, France.|Inserm Unit 1016, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Prat
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D000069916:Endoscopic Mucosal Resection / Q000009:adverse effects / Q000379:methods; D004940:Esophageal Stenosis / Q000209:etiology / Q000517:prevention & control*; D016629:Esophagectomy / Q000009:adverse effects* / Q000379:methods; D004947:Esophagus / Q000601:surgery; D005109:Extracellular Matrix / Q000737:chemistry*; D010455:Peptides; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011897:Random Allocation; D013552:Swine; D016896:Treatment Outcome; D058106:Wound Closure Techniques
chemical_list: D010455:Peptides
keywords: endoscopic submucosal dissection (ESD); esophageal fibrosis; esophageal stricture; self-assembling peptide