Polyglycolic acid sheet plus esophageal stent presents with higher efficacy in preventing esophageal stricture post endoscopic submucosal dissection compared with stent placement alone in early-stage esophageal cancer patients

This study aimed to investigate the effect of polyglycolic acid (PGA) plus stent therapy compared with stent alone therapy on preventing post-endoscopic submucosal dissection (ESD) esophageal stricture in patients with early-stage esophageal cancer (EC). This prospective cohort study recruited 75 patients who underwent ESD for early-stage EC, including 38 patients who received PGA plus stent therapy (PGA+stent group) and 37 patients who received only stent placement (stent group). Incidence of postoperative stricture after esophageal ESD, the days to esophageal stricture, location, length and diameter of esophageal stricture as well as balloon dilatation times for the esophageal stricture were evaluated. 13.2% (n = 5) patients in PGA+stent group developed esophageal stricture, which was lower compared with stent group (35.1% (n = 13), P = 0.026). In the patients with esophageal stricture, length of esophageal stricture in PGA+stent group was numerically shorter than that in stent group (P = 0.050). While no difference in time to esophageal stricture (P = 0.286), diameter of esophageal stricture (P = 0.103), esophageal stricture distance from the incisions (P = 0.917) or balloon dilatation time (P = 0.173) was found between PGA+stent group and stent group. In addition, Multivariate logistic regression analysis revealed that PGA+stent (vs. stent, P = 0.021) was an independent predictive factor for lower possibility of esophageal stricture. In conclusion, PGA plus stent placement therapy achieved lower occurrence of post-ESD esophageal stricture as well as numerically lighter esophageal stricture severity compared with stent placement therapy alone in early-stage EC patients.