Prospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Dec 16, 2023; 15(12): 725-734
Published online Dec 16, 2023. doi: 10.4253/wjge.v15.i12.725
New hope for esophageal stricture prevention: A prospective single-center trial on acellular dermal matrix
Xin-Yu Fu, Zhen-Yu Jiang, Chen-Yang Zhang, Ling-Yan Shen, Xiao-Dan Yan, Xiao-Kang Li, Jia-Ying Lin, Yi Wang, Xin-Li Mao, Shao-Wei Li
Xin-Yu Fu, Chen-Yang Zhang, Jia-Ying Lin, Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
Zhen-Yu Jiang, Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014000, Inner Mongolia Autonomous Region, China
Ling-Yan Shen, Xiao-Dan Yan, Yi Wang, Xin-Li Mao, Shao-Wei Li, Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
Xiao-Kang Li, Shao-Wei Li, Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
Xiao-Kang Li, Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo 1540001, Japan
Shao-Wei Li, Institute of Digestive Disease, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
Co-first authors: Xin-Yu Fu and Zhen-Yu Jiang.
Co-corresponding authors: Shao-Wei Li and Xin-Li Mao.
Author contributions: Fu XY, Zhang CY, Lin JY, Yan XD, Li XK, Wang Y, and Mao XL participated in the design of the study and performed the statistical analysis; Fu XY, Jiang ZY, Zhang CY, Lin JY, and Li SW drafted the manuscript. All authors read and approved the final manuscript.
Supported by Medical Health Science and Technology Project of Zhejiang Province, No. 2021PY083, 2019KY239; Program of Taizhou Science and Technology Grant, No. 23ywa33; Major Research Program of Taizhou Enze Medical Center Grant, No. 19EZZDA2; Open Fund of Key Laboratory of Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, No. 21SZDSYS01 and No. 21SZDSYS09; Program of Taizhou Enze Medical Center Grant, No. 22EZD06.
Institutional review board statement: This prospective, single-center, controlled study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Taizhou Hospital, Zhejiang Province, under the Institutional Review Board of Wenzhou Medical University (autologous mucosa transplantation approval number: K20190123; ADM transplantation approval number: X20190603).
Clinical trial registration statement: The study was registered with the Center for Clinical Trials under registration number ChiCTR200040119.
Informed consent statement: All study participants, or their legal guardian, provided written consent prior to study enrollment.
Conflict-of-interest statement: All the authors declare that they have no conflict interests to disclose.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT Statement—checklist of items, and the manuscript was prepared and revised according to the CONSORT Statement—checklist of items.
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: Shao-Wei Li, PhD, Associate Professor, Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, No. 150 Xinmen Street, Linhai 317000, Zhejiang Province, China. li_shaowei81@hotmail.com
Received: August 5, 2023
Peer-review started: August 5, 2023
First decision: October 9, 2023
Revised: October 22, 2023
Accepted: November 3, 2023
Article in press: November 3, 2023
Published online: December 16, 2023
Processing time: 132 Days and 0.1 Hours
ARTICLE HIGHLIGHTS
Research background

Mucosal autograft transplantation has been reported to be effective in preventing esophageal stricture after endoscopic submucosal dissection (ESD) for esophageal cancer.

Research motivation

The preparation of autologous mucosa is an intricate process that demands a significant amount of time, potentially delaying the treatment of diseases. It is imperative to explore potential substitutes for autologous mucosa.

Research objectives

The efficacy of acellular dermal matrix (ADM) in preventing esophageal stricture is equivalent to that of autologous mucosal transplantation and has a substitutive effect.

Research methods

This is a prospective, single-center controlled study. Patients who underwent ESD surgery and were willing to undergo autologous mucosal transplantation and ADM transplantation were consecutively recruited for the study. A three-year follow-up was conducted for the transplanted patients.

Research results

Autologous mucosal grafts and ADM grafts demonstrated no significant differences in preventing esophageal stenosis, exhibiting similar preventive effects against esophageal narrowing.

Research conclusions

ADM possesses the potential to prevent esophageal stricture, exhibiting comparable preventative efficacy to autologous mucosal grafts while providing substitutive benefits.

Research perspectives

We shall persist in our research endeavors, enlisting additional participants to further validate the efficacy of ADM in preventing esophageal stricture. This shall furnish a multitude of options and avenues towards the treatment of esophageal stenosis.