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Prevention of esophageal strictures after endoscopic submucosal dissection


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Title: Prevention of esophageal strictures after endoscopic submucosal dissection
Authors: Kobayashi, Shinichiro / Kanai, Nobuo / Ohki, Takeshi / Takagi, Ryo / Yamaguchi, Naoyuki / Isomoto, Hajime / Kasai, Yoshiyuki / Hosoi, Takahiro / Nakao, Kazuhiko / Eguchi, Susumu / Yamamoto, Masakazu / Yamato, Masayuki / Okano, Teruo
Issue Date: 7-Nov-2014
Publisher: WJG Press
Citation: World Journal of Gastroenterology, 20(41), 15098; 2014
Abstract: Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have recently been accepted as less invasive methods for treating patients with early esophageal cancers such as squamous cell carcinoma and dysplasia of Barrett's esophagus. However, the large defects in the esophageal mucosa often cause severe esophageal strictures, which dramatically reduce the patient's quality of life. Although preventive endoscopic balloon dilatation can reduce dysphagia and the frequency of dilatation, other approaches are necessary to prevent esophageal strictures after ESD. This review describes several strategies for preventing esophageal strictures after ESD, with a particular focus on anti-inflammatory and tissue engineering approaches. The local injection of triamcinolone acetonide and other systemic steroid therapies are frequently used to prevent esophageal strictures after ESD. Tissue engineering approaches for preventing esophageal strictures have recently been applied in basic research studies. Scaffolds with temporary stents have been applied in five cases, and this technique has been shown to be safe and is anticipated to prevent esophageal strictures. Fabricated autologous oral mucosal epithelial cell sheets to cover the defective mucosa similarly to how commercially available skin products fabricated from epidermal cells are used for skin defects or in cases of intractable ulcers. Fabricated autologous oralmucosal- epithelial cell sheets have already been shown to be safe.
Keywords: Autologous oral mucosal epithelial cell sheet / Endoscopic submucosal dissection / Esophageal stricture / Systemic steroid therapy
URI: http://hdl.handle.net/10069/34995
ISSN: 10079327
DOI: 10.3748/wjg.v20.i41.15098
Rights: ©1995-2014 Baishideng Publishing Group Inc. All rights reserved. Articles published by this open-access journal are distributed under the terms of the Creative Commons Attribution-Noncommercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/34995

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