Endoscopy 2017; 49(04): 359-364
DOI: 10.1055/s-0042-120997
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

A novel and effective delivery method for polyglycolic acid sheets to post-endoscopic submucosal dissection ulcers

Toshitatsu Takao
1   Division of Gastroenterology, Kobe University, Kobe, Hyogo, Japan
,
Yoshitaka Takegawa
2   The Chemo-Sero-Therapeutic Research Institute, Kumamoto-shi, Japan
,
Hiroyuki Ono
3   Endoscopy Division, Shizuoka Cancer Center Hospital, Nagaizumi, Shizuoka, Japan
,
Madoka Takao
1   Division of Gastroenterology, Kobe University, Kobe, Hyogo, Japan
,
Shiro Oka
2   The Chemo-Sero-Therapeutic Research Institute, Kumamoto-shi, Japan
,
Noriko Shinya
2   The Chemo-Sero-Therapeutic Research Institute, Kumamoto-shi, Japan
,
Hiromu Kutsumi
4   Center for Clinical Research and Advanced Medicine Establishment Shiga University of Medical Science, Otsu, Shiga, Japan
,
Takeshi Azuma
1   Division of Gastroenterology, Kobe University, Kobe, Hyogo, Japan
› Author Affiliations
Further Information

Publication History

submitted 11 April 2016

accepted after revision 14 October 2016

Publication Date:
19 January 2017 (online)

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Abstract

Background and aims Shielding methods for post-endoscopic submucosal dissection (ESD) ulcers have delivery-related problems. We developed an enveloped device for this purpose and evaluated its usefulness.

Materials and methods Polyglycolic acid (PGA) sheets were delivered to six 3.0-cm ulcers in two resected porcine stomachs and six 5.0-cm ulcers in another three stomachs. In the regular method group, small PGA sheets were delivered via forceps. In the novel method group, a large PGA sheet was delivered via the new device. The methods were compared in terms of time, and macroscopic and histological findings of the ulcer floor.

Results The median time required to cover a 3.0-cm ulcer was 0.39 min/cm2 in the novel method group and 1.03 min/cm2 in the regular method group (P = 0.03), and to cover a 5.0-cm ulcer was 0.38 min/cm2 and 0.85 min/cm2, respectively (P = 0.03). In the novel method group, the PGA sheets were in close contact, fully covering the ulcer floor. In the regular method group, the sheets were partly elevated from the ulcer floor.

Conclusions This novel technique seems promising in this preliminary study.