应用聚乙醇酸片预防食管鳞状细胞癌内镜黏膜下剥离术后食管狭窄。

Polyglycolic acid sheet application to prevent esophageal stricture after endoscopic submucosal dissection for esophageal squamous cell carcinoma.

作者信息

Iizuka Toshiro, Kikuchi Daisuke, Yamada Akihiro, Hoteya Shu, Kajiyama Yoshiaki, Kaise Mitsuru

机构信息

Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.

Department of Upper Gastrointestinal Surgery, Juntendo University, Tokyo, Japan.

出版信息

Endoscopy. 2015 Apr;47(4):341-4. doi: 10.1055/s-0034-1390770. Epub 2014 Nov 20.

DOI:10.1055/s-0034-1390770

PMID:25412087

Abstract

BACKGROUND AND STUDY AIM

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.

PATIENTS AND 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.

CONCLUSION

PGA sheets may have the potential to prevent esophageal stricture.

摘要

背景与研究目的

内镜黏膜下剥离术（ESD）后食管狭窄可能是有大面积黏膜缺损患者的严重并发症。本初步研究探讨了使用聚乙醇酸（PGA）片联合纤维蛋白胶预防ESD后食管狭窄的疗效。

患者与方法

共纳入15例患者。切除术后，将PGA片置于手术创面。通过将食管周长等分为12个大小相等的部分来估计黏膜缺损的大小。调查6周时食管狭窄的发生情况，以及ESD后1周和2周PGA片仍在位的患者比例和不良事件的发生情况。

结果

15例患者的黏膜缺损大小分别为7/12（n = 4）、8/12（n = 5）、9/12（n = 4）、10/12（n = 1）和11/12（n = 1）。13例患者中有1例发生食管狭窄（7.7%；2例患者因在随访期间需要手术切除而未纳入分析）。15例患者中有13例（86.7%）在ESD后1周时PGA片仍在位，15例患者中有6例（40%）在ESD后2周时PGA片仍在位。未观察到不良事件。