Prevention of esophageal stricture after circumferential endoscopic submucosal dissection using a modified self-assembling peptide
| Autor: | Frédéric Beuvon, Maximilien Barret, Carole Nicco, Frédéric Prat, Sarra Oumrani, Charlotte Chêne, Frédéric Batteux |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Esophageal Mucosa Triamcinolone acetonide Endoscopic Mucosal Resection Esophageal Neoplasms Swine Barrett Esophagus 03 medical and health sciences 0302 clinical medicine Fibrosis Animals Medicine Endoscopic resection Major complication Esophagus medicine.diagnostic_test business.industry Gastroenterology General Medicine Endoscopic submucosal dissection medicine.disease Surgery Endoscopy medicine.anatomical_structure 030220 oncology & carcinogenesis Esophageal stricture Esophageal Stenosis 030211 gastroenterology & hepatology Peptides business medicine.drug |
| Zdroj: | Diseases of the Esophagus. 34 |
| ISSN: | 1442-2050 1120-8694 |
| DOI: | 10.1093/dote/doaa133 |
| Popis: | Summary Circumferential endoscopic resection (ER) of the esophageal mucosa could find its place in the treatment of dysplastic Barrett’s esophagus or extensive squamous cell neoplasia. However, the occurrence of esophageal strictures remains a major complication after ER exceeding 75% of the circumference. The aim of this study was to assess the effect of a modified, pH = 2, self-assembling peptide matrix (4[Arg-Ala-Asp-Ala]) (SAP) on the development of esophageal stricture after circumferential ER in a swine model. We performed a circumferential ER in 35 swine under general anesthesia. Five animals were included in the control group, 11 animals received the SAP matrix immediately after the resection, and 11 received the SAP matrix associated to a local steroid immediately after the resection. Follow-up endoscopy and esophagogram were performed before slaughter and necropsy at day 14. Eight treated animals were kept alive until day 28. At day 14, 27% of the animals in the SAP group developed a symptomatic stricture versus 100% in the control group (P = 0.008) and 50% in the SAP-triamcinolone group (P = 0.11). Application of an SAP matrix after circumferential ER in the swine allowed a significant reduction of the incidence of symptomatic stricture at day 14. Adding triamcinolone brought no significant improvement. |
| Databáze: | OpenAIRE |
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