Effect of polyglycolic acid sheet plus esophageal stent placement in preventing esophageal stricture after endoscopic submucosal dissection in patients with early-stage esophageal cancer: A randomized, controlled trial

Figure 1 Combination of polyglycolic acid sheet and stent. A: Measurement of endoscopic submucosal dissection wound length; B: Adjustment of stent length; C: Polyglycolic acid sheet selection based on lesion length; D: Stent coating with polyglycolic acid (PGA) sheet; E-F: Stent covered with PGA sheet mounted on the stent support; G: Insertion of stent covered with PGA sheet under endoscopic observation.

Figure 2 The management of one of the study patients. A: Stent covered with polyglycolic acid sheet inserted after 1 wk; B: Stent removed after 4 wk with a portion of wound not healed; C: No formation of esophageal stricture observed after 2 mo.

Figure 3 Study flow. ESD: Endoscopic submucosal dissection.

Figure 4 Comparison of post-endoscopic submucosal dissection stricture in polyglycolic acid plus stent and stent groups. A: Patients in the polyglycolic acid (PGA) plus stent group had a lower occurrence rate of esophageal stricture than that in the stent group; B: No difference in time to esophageal stricture was observed between the PGA plus stent and stent groups. Comparison of post-endoscopic submucosal dissection stricture in the PGA plus stent and stent groups was performed by t-test. P < 0.05 was considered significant.

Figure 5 The endoscopic submucosal dissection wound before and after the polyglycolic acid sheet plus stent placement. A: The esophageal lesion before endoscopic submucosal dissection (ESD); B: The mucosal defect after ESD; C: The ESD wound after the PGA sheet plus stent placement; D: The PGA sheet plus stent placement was inserted after 3 wk.

Figure 6 The management of one of the study patients. A: Stent covered with polyglycolic acid (PGA) sheet was injected with glucocorticoid before insertion; B: The mucosal defect after endoscopic submucosal dissection (ESD); C: The combination of PGA, stent, and glucocorticoid was applied after 1 wk; D: The endoscopic appearance of the esophagus 4 wk after ESD; E: The endoscopic appearance of the esophagus 3 mo after ESD.