Advances in the application of regenerative medicine in prevention of post-endoscopic submucosal dissection for esophageal stenosis

Abstract

Endoscopic submucosal dissection (ESD) is a curative treatment for superficial esophageal cancer with distinct advantages. However, esophageal stenosis after ESD remains a tough problem, especially after large circumferential proportion of esophageal mucosa is removed, which limits the wide use of ESD, especially in circumferential lesions. In this scenario, preventive procedures are highly recommended against post-ESD esophageal stenosis. However, the efficacy and safety of traditional prophylactic methods (steroids, metal and biodegradable stents, balloon dilation, radial incision, etc.) are not satisfactory and novel strategies need to be developed. Regenerative medicine has been showing enormous potential in the reconstruction of organs including the esophagus. In this review, we aimed to describe the current status of regenerative medicine in prevention of post-ESD esophageal stenosis. Cell injection, cell sheet transplantation, and extracellular matrix implantation have been proved effective. However, numerous obstacles still exist and further studies are necessary.

A novel risk score model of esophageal stricture for patients undergoing endoscopic submucosal dissection

“…Steroid injection therapy and oral steroid administration are the mainstream. Many other clinical applications have also been developed, such as tissue shielding methods with polyglycolic acid sheet, autologous oral mucosal epithelial sheet transplantation, and stent placement [22][23][24][25][26]. However, it would be better if these preventive procedures are adopted before the stricture happens.…”

Endoscopic diagnosis and treatment of superficial non-ampullary duodenal epithelial tumors: A review

“…Similar to the endoscopic treatment for colorectal polyps, the choices for SNADETs mainly include cold snare polypectomy (CSP), EMR, underwater EMR (UEMR), ESD, and laparoscopic endoscopic cooperative surgery (LECS). [ 60 , 61 , 62 ] However, characterized by a narrow lumen, rich vascularity, weak muscle layer, abundant Brunner’s gland, and the hardship of endoscope control, the duodenum ranks as one of the most dangerous operating areas in the digestive tract. [ 63 ] Furthermore, unlike the intensive experience in colonoscopy, [ 64 ] the experience of endoscopic treatment in the duodenum remains limited.…”

A deep learning–based system to identify originating mural layer of upper gastrointestinal submucosal tumors under EUS

“…[ 1 , 2 ] Compared with computed tomography and magnetic resonance imaging, [ 3 ] EUS is considered the most accurate procedure for detecting and diagnosing SMTs owing to its unique ability to examine tumors with high proximity. [ 4 – 9 ] Besides, EUS is the only imaging technique that can delineate the separate histologic layers of the GI tract. [ 10 , 11 ]…”