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Endoscopy 2018; 50(10): 1017-1021
DOI: 10.1055/a-0622-8019
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic mucosal autograft for treating esophageal caustic strictures: preliminary human experience

Kexin He   *
1   Digestive Endoscopy Department, The First Affiliated Hospital with Nanjing Medical University, China
,
Lili Zhao   *
1   Digestive Endoscopy Department, The First Affiliated Hospital with Nanjing Medical University, China
,
Shoushan Bu
2   Department of Stomatology, The First Affiliated Hospital with Nanjing Medical University, China
,
Li Liu
1   Digestive Endoscopy Department, The First Affiliated Hospital with Nanjing Medical University, China
,
Xiang Wang
1   Digestive Endoscopy Department, The First Affiliated Hospital with Nanjing Medical University, China
,
Min Wang
1   Digestive Endoscopy Department, The First Affiliated Hospital with Nanjing Medical University, China
,
Zhining Fan
1   Digestive Endoscopy Department, The First Affiliated Hospital with Nanjing Medical University, China
› Author Affiliations
Further Information

Publication History

submitted 14 September 2017

accepted after revision 21 March 2018

Publication Date:
11 June 2018 (online)

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Abstract

Background Esophageal caustic stricture is a stubborn disease and postoperative restenosis limits the clinical efficacy of endoscopic dilation. Autologous mucosal grafts have been successfully applied in the treatment of urethral stricture and in the prevention of stricture after extensive mucosal resection. We aimed to use mucosal autografting performed endoscopically to treat refractory esophageal stricture.

Methods Three patients with intractable corrosive esophageal stricture were treated endoscopically by combining dilation with autologous mucosal transplantation.

Results All procedures were successful with no severe complications. Mucosal regeneration was shown at the transplanted segments. One patient was able to maintain a normal diet with complete remission after 1 year of follow-up. Intraluminal stenosis and dysphagia were significantly improved in another two patients.

Conclusions Mucosal autografting can achieve esophageal re-epithelialization, inhibit undesired fibrosis, prevent restenosis, and promote functional regeneration.

* These authors contributed equally to this work.


Supplementary material Appendix e1, Table e1, Figs. e2, e4, e5, e6, e7, e8

 

  • References

  • 1 Zhang C, Zhou X, Yu L. et al. Endoscopic therapy in the treatment of caustic esophageal stricture: a retrospective case series study. Dig Endosc 2013; 25: 490-495
    CrossrefPubMedSearch in Google Scholar
  • 2 Harlak A, Yigit T, Coskun K. et al. Surgical treatment of caustic esophageal strictures in adults. Int J Surg 2013; 11: 164-168
    CrossrefPubMedSearch in Google Scholar
  • 3 Zhang Y, Wang X, Liu L. et al. Intramuscular injection of mitomycin C combined with endoscopic dilation for benign esophageal strictures. J Dig Dis 2015; 16: 370-376
    CrossrefPubMedSearch in Google Scholar
  • 4 Ohki T, Yamato M, Ota M. et al. Prevention of esophageal stricture after endoscopic submucosal dissection using tissue-engineered cell sheets. Gastroenterology 2012; 143: 582-588.e582
    CrossrefPubMedSearch in Google Scholar
  • 5 Warner JN, Wisenbaugh ES, Martins FE. Bulbar urethral stricture: How to optimise the use of buccal mucosal grafts. Arab J Urol 2016; 14: 78-83
    CrossrefPubMedSearch in Google Scholar
  • 6 Kochman ML, McClave SA, Boyce HW. The refractory and the recurrent esophageal stricture: a definition. Gastrointest Endosc 2005; 62: 474-475
    CrossrefPubMedSearch in Google Scholar
  • 7 El-Asmar KM, Hassan MA, Abdelkader HM. et al. Topical mitomycin C application is effective in management of localized caustic esophageal stricture: a double-blinded, randomized, placebo-controlled trial. J Pediatr Surg 2013; 48: 1621-1627
    CrossrefPubMedSearch in Google Scholar
  • 8 Kochhar R, Ray JD, Sriram PV. et al. Intralesional steroids augment the effects of endoscopic dilation in corrosive esophageal strictures. Gastrointest Endosc 1999; 49: 509-513
    CrossrefPubMedSearch in Google Scholar
  • 9 Kochhar R, Poornachandra KS. Intralesional steroid injection therapy in the management of resistant gastrointestinal strictures. World J Gastrointest Endosc 2010; 2: 61-68
    PubMedSearch in Google Scholar
  • 10 Knez EvicJ, Radovanovic NS, Simic AP. et al. Colon interposition in the treatment of esophageal caustic strictures: 40 years of experience. Dis Esophagus 2007; 20: 530-534
    CrossrefPubMedSearch in Google Scholar
  • 11 Spaander MC, Baron TH, Siersema PD. et al. Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2016; 48: 939-948
    Thieme ConnectPubMedSearch in Google Scholar
  • 12 Nikolavsky D, Manwaring J, Bratslavsky G. et al. Novel concept and method of endoscopic urethral stricture treatment using liquid buccal mucosal graft. J Urol 2016; 196: 1788-1795
    CrossrefPubMedSearch in Google Scholar
  • 13 Hochberger J, Koehler P, Wedi E. et al. Transplantation of mucosa from stomach to esophagus to prevent stricture after circumferential endoscopic submucosal dissection of early squamous cell. Gastroenterology 2014; 146: 906-909
    CrossrefPubMedSearch in Google Scholar