Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jan 16, 2024; 16(1): 1-4
Published online Jan 16, 2024. doi: 10.4253/wjge.v16.i1.1
Prospects of polyglycolic acid sheets for the treatment of esophageal stricture after esophageal endoscopic submucosal dissection
Qing-Xia Wang, Rui-Hua Shi
Qing-Xia Wang, Rui-Hua Shi, Department of Gastroenterology, Southeast University Affiliated Zhongda Hospital, Medical School, Nanjing 210009, Jiangsu Province, China
Author contributions: Wang QX and Shi RH contributed to this paper; Wang QX designed the overall concept and wrote the manuscript; Shi RH contributed to the discussion and design of the manuscript.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rui-Hua Shi, PhD, Department of Gastroenterology, Southeast University Affiliated Zhongda Hospital, Medical School, No. 87 Dingjiaqiao, Nanjing 210009, Jiangsu Province, China. ruihuashi@126.com
Received: September 26, 2023
Peer-review started: September 26, 2023
First decision: December 7, 2023
Revised: December 12, 2023
Accepted: December 29, 2023
Article in press: December 29, 2023
Published online: January 16, 2024

Esophageal cancer is the seventh most common type of cancer and the sixth leading cause of cancer -related mortality worldwide. Endoscopic submucosal dissection (ESD) is widely used for the resection of early esophageal cancer. However, post-ESD esophageal stricture is a common long-term complication, which requires attention. Patients with post-ESD esophageal stricture often experience dysphagia and require multiple dilatations, which greatly affects their quality of life and increases healthcare costs. Therefore, to manage post-ESD esophageal stricture, researchers are actively exploring various strategies, such as pharmaceutical interventions, endoscopic balloon dilation, and esophageal stenting. Although steroids-based therapy has achieved some success, steroids can lead to complications such as osteoporosis and infection. Meanwhile, endoscopic balloon dilatation is effective in the short term, but is prone to recurrence and perforation. Additionally, esophageal stenting can alleviate the stricture, but is associated with discomfort during stenting and the complication of easy displacement also present challenges. Tissue engineering has evolved rapidly in recent years, and hydrogel materials have good biodegradability and biocompatibility. A novel type of polyglycolic acid (PGA) sheets has been found to be effective in preventing esophageal stricture after ESD, with the advantages of a simple operation and low complication rate. PGA membranes act as a biophysical barrier to cover the wound as well as facilitate the delivery of medications to promote wound repair and healing. However, there is still a lack of multicenter, large-sample randomized controlled clinical studies focused on the treatment of post-ESD esophageal strictures with PGA membrane, which will be a promising direction for future advancements in this field.

Keywords: Polyglycolic acid, Endoscopic submucosal dissection, Esophageal stenosis, Esophageal cancer, Steroids

Core Tip: Esophageal cancer is the seventh most common type of cancer and the sixth leading cause of cancer death worldwide. Endoscopic submucosal dissection (ESD) is considered a prominent method for early esophageal cancer resection. However, esophageal stenosis is a common complication of esophageal ESD. A novel hydrogel material, polyglycolic acid sheet, is safe and effective for the prevention of esophageal strictures after ESD.