A
                    basic study of the effect of the shielding method with polyglycolic acid fabric
                    and fibrin glue after endoscopic submucosal
                dissection

Tsujimoto Hiroyuki; Yamanaka Kohki; Miyamoto Hiroe; Horii Tsunehito; Abe Rie; Tanaka Shota; Torii Hiroko; Ozamoto Yuki; Toshitaka Takagi; Takimoto Kengo; Torii Takashi; Konishi Hideyuki; Takamori Hideki; Hagiwara Akeo

doi:10.1055/s-0042-118208

Endoscopy International Open, Table of Contents

Endosc Int Open 2016; 04(12): E1298-E1304
DOI: 10.1055/s-0042-118208

Original article

A basic study of the effect of the shielding method with polyglycolic acid fabric and fibrin glue after endoscopic submucosal dissection

Tsujimoto Hiroyuki

¹Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan

,

Yamanaka Kohki

¹Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan

,

Miyamoto Hiroe

¹Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan

,

Horii Tsunehito

¹Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan

,

Abe Rie

¹Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan

,

Tanaka Shota

¹Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan

,

Torii Hiroko

¹Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan

,

Ozamoto Yuki

¹Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan

,

Toshitaka Takagi

¹Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan

,

Takimoto Kengo

²Department of Gastroenterology, Takeda Central Hospital, Kyoto, Japan

,

Torii Takashi

³Department of Gastroenterology, Kyoto Prefectural University of Medicine, Kyoto, Japan

,

Konishi Hideyuki

³Department of Gastroenterology, Kyoto Prefectural University of Medicine, Kyoto, Japan

,

Takamori Hideki

⁴QOL Institute, Gunze Ltd., Ayabe, Kyoto, Japan

,

Hagiwara Akeo

¹Division of Medical Life System, Department of Medical Life System, Doshisha University, Kyotanabe, Kyoto, Japan

› Author Affiliations

Abstract

Background and study aims: Recently, the shielding method with polyglycolic acid (PGA) fabric and fibrin glue (P-F method) has been reported to prevent serious complications after endoscopic submucosal dissection (ESD). However, the effectiveness and mechanism to prevent complications by this method remain unclear and the corresponding basic research has not been fully conducted.

Methods and results: We examined the effectiveness and mechanism of the P-F method, using a surgical ESD model of canine stomach and in vitro experiments. In the model experiment treated by P-F method or no treatment (control), ulcer perforation or penetration occurred only in the control group, but not in the P-F group. Microscopically, the P-F group showed less damages of the ulcer lesion than that of the control group, showing thicker granulation tissues including PGA fibers on the third day and excellent mucosal regeneration on the fourteenth day. In vitro culture experiments showed that fibroblasts proliferated at a significantly higher rate on PGA than on fibrin or a complex thereof. However, under hydrochloric acid treatment, fibroblasts were protected by fibrin, followed by the complex of both, and PGA.

Conclusion: The P-F method exhibited a protective effect against gastric juice by fibrin glue to reduce tissue damages and a scaffold function of PGA fabric to induce better granulation formation at the earlier phase, resulting in excellent long-term tissue repair, on ulcer lesion following ESD, although the results were based on basic experiments.

Full Text

References

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