Prevention of esophageal strictures after endoscopic submucosal dissection

被引:42
作者
Kobayashi, Shinichiro [1 ,2 ]
Kanai, Nobuo [1 ,3 ]
Ohki, Takeshi [1 ,3 ]
Takagi, Ryo [1 ]
Yamaguchi, Naoyuki [1 ,4 ]
Isomoto, Hajime [4 ]
Kasai, Yoshiyuki [1 ,5 ]
Hosoi, Takahiro [1 ,6 ]
Nakao, Kazuhiko [4 ]
Eguchi, Susumu [2 ]
Yamamoto, Masakazu [3 ]
Yamato, Masayuki [1 ]
Okano, Teruo [1 ]
机构
[1] Tokyo Womens Med Univ, Inst Adv Biomed Engn & Sci, Tokyo 1628666, Japan
[2] Nagasaki Univ, Grad Sch Biomed Sci, Dept Surg, Nagasaki 8528102, Japan
[3] Tokyo Womens Med Univ, Inst Gastroenterol, Dept Surg, Tokyo 1628666, Japan
[4] Nagasaki Univ, Grad Sch Biomed Sci, Dept Gastroenterol & Hepatol, Nagasaki 8528102, Japan
[5] Waseda Univ, Grad Sch Adv Sci & Engn, Life Sci & Med Biosci, Tokyo 1628480, Japan
[6] Tokyo Univ Sci, Grad Sch Pharmaceut Sci, Dept Pharmaceut Sci, Chiba 2788501, Japan
关键词
Endoscopic submucosal dissection; Esophageal stricture; Systemic steroid therapy; Autologous oral mucosal epithelial cell sheet; SQUAMOUS-CELL CARCINOMA; INTRALESIONAL STEROID INJECTION; MUCOSAL RESECTION; BARRETTS-ESOPHAGUS; MITOMYCIN-C; STEM-CELLS; SUPERFICIAL ADENOCARCINOMA; RADIOFREQUENCY ABLATION; TRIAMCINOLONE INJECTION; MUSCULARIS MUCOSAE;
D O I
10.3748/wjg.v20.i41.15098
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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 oral-mucosal-epithelial cell sheets have already been shown to be safe. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
引用
收藏
页码:15098 / 15109
页数:12
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