|Table of Contents|

Fibrin glue and triamcinolone acetonide prevent postoperative esophageal stenosis after endoscopic submucosal dissection in a canine model

(PDF)

《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

Issue:
2018年第11期
Page:
979-983
Research Field:
基础医学
Publishing date:

Info

Title:

Fibrin glue and triamcinolone acetonide prevent postoperative esophageal stenosis after endoscopic submucosal dissection in a canine model

Author(s):

JIA Yijun WU Hongbo WANG Ling QIN Yusi PENG Guiyong

Institute of Gastroenterology, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China

Keywords:

fibrin gluetriamcinolone acetonideesophageal stenosisendoscopic submucosal dissection

PACS:
R619; R655.4; R969.4
DOI:
-
Abstract:

Objective     To investigate the preventive efficacy of fibrin glue supplementation with triamcinolone acetonide in a dog model of post-endoscopic esophageal dissection (ESD). Methods    Twenty 12-month-old domestic dogs in good condition (both sexes, 12 to 15 kg), were randomly divided into 4 groups (n=5): fibrin gluetriamcinolone acetonide treatment group (FT), fibrin glue treatment group (F), triamcinolone acetonide treatment group (T) and control group. ESD model was inflicted by exfoliating three-quarters circumference of esophageal mucosa in 30~34 cm away from the incisor. Then fibrin glue suspensions with triamcinolone acetonide, fibrin glue solution or triamcinolone acetonide solution were correspondingly sprayed to cover the ulcer wound after ESD, respectively, and no drug was applied for the control group. Gross observation, stenosis rate, and HE staining and immunohistochemical examination of α-SMA for the stenosis tissues were performed in 6 weeks after ESD.  Results     Mucosal folds were sighted under endoscopy but in which a thinner esophageal wall was noted in macropathology. The dogs in the FT group gained a lower mucosal stenosis rate as to the dogs in the T group (P<0.05) and control group (P<0.01), and a similar lower rate happened in the comparison with the dogs from the F group to the control group (P<0.05). HE staining displayed atrophy in the muscularis propria, extensive myofibroblasts and collagen fibers in submucosa layer in the control group. Compared with the FT group, the expression level of α-SMA was augmented in the T -group and control group (P<0.01), as well as in the T group (P<0.01) and control group (P<0.05) when compared with the F group. Conclusion      Spraying fibrin glue-triamcinolone acetonide suspensions or fibrin glue alone can relieve esophageal post-ESD stenosis, probably via alleviating submucosa fibrosis and inflammation, but a single dose of triamcinolone acetonide does not work.

References:

[1]KOBAYASHI S, KANAI N, OHKI T, et al. Prevention of esophageal strictures after endoscopic submucosal dissection[J]. World J Gastroenterol, 2014, 20(41): 15098-15109.DOI:10.3748/wjg.v20.i41.15098.
[2]WEN J, LU Z, LIU Q. Prevention and treatment of esophageal stenosis after endoscopic submucosal dissection for early esophageal cancer[J]. Gastroenterol Res Pract, 2014,2014:457101.DOI:10.1155/2014/457101.
[3]IIZUKA T, KIKUCHI D, YAMADA A, et al. Polyglycolic acid sheet application to prevent esophageal stricture after endoscopic submucosal dissection for esophageal squamous cell carcinoma[J]. Endoscopy, 2015,47(4): 341-344.DOI:10.1055/s-0034-1390770.
[4]SAKAGUCHI Y, TSUJI Y, ONO S, et al. Polyglycolic acid sheets with fibrin glue can prevent esophageal stricture after endoscopic submucosal dissection[J]. Endoscopy, 2015, 47(4): 336-340.DOI:10.1055/s0034-1390787.
[5]BARRET M, BORDACAHAR B, BEUVON F, et al. Self-assembling peptide matrix for the prevention of esophageal stricture after endoscopic resection: a randomized controlled trial in a porcine model[J]. Dis Esophagus, 2017, 30(5): 1-7.DOI:10.1093/dote/dow015.
[6]HONDA M, NAKAMURA T, HORI Y, et al. Feasibility study of corticosteroid treatment for esophageal ulcer after EMR in a canine model[J]. J Gastroenterol, 2011, 46(7): 866-872.DOI:10.1007/s00535-0110400-3.
[7]KATAOKA M, ANZAI S, SHIRASAKI T, et al. Efficacy of short period, low dose oral prednisolone for the prevention of stricture after circumferential endoscopic submucosal dissection (ESD) for esophageal cancer[J]. Endosc Int Open, 2015, 3(2): E113-117.DOI:10.1055/s-0034-1390797.
[8]KIM B S, SHKEMBI F, LEE J. In vitro and in vivo evaluation of commercially available fibrin gel as a carrier of alendronate for bone tissue engineering[J]. Biomed Res Int, 2017, 2017:6434169.DOI:10.1155/2017/6434169.
[9]MIZUSHIMA T, OHNISHI S, HOSONO H, et al. Oral administration of conditioned medium obtained from mesenchymal stem cell culture prevents subsequent stricture formation after esophageal submucosal dissection in pigs[J]. Gastrointest Endosc, 2017: 10.1016/j.gie.2017.01.024.
[10]OHKI T, YAMATO M, OTA M, et al. Application of regenerative medical technology using tissueengineered cell sheets for endoscopic submucosal dissection of esophageal neoplasms[J]. Dig Endosc, 2015, 27(2): 182-188.DOI:10.1111/den.12354.
[11]HONDA M, HORI Y, NAKADA A, et al. Use of adipose tissuederived stromal cells for prevention of esophageal stricture after circumferential EMR in a canine model[J]. Gastrointest Endosc, 2011, 73(4): 777-784.DOI:10.1016/j.gie.2010.11.008.
[12]IIZUKA T, KIKUCHI D, HOTEYA S, et al. Polyglycolic acid sheet and fibrin glue for preventing esophageal stricture after endoscopic submucosal dissection: a historical control study[J]. Dis Esophagus, 2017, 30(11): 1-8. DOI:10.1093/dote/dox053.
[13]KATAOKA Y, TSUJI Y, SAKAGUCHI Y, et al. Preventing esophageal stricture after endoscopic submucosal dissection: steroid injection and shielding with polyglycolic acid sheets and fibrin glue[J]. Endoscopy, 2015, 47 Suppl 1 UCTN:E473-474.DOI:10.1055/s00341392975.
[14]PETRATOS P B, FELSEN D, TRIERWEILER G, et al. Transforming growth factorbeta2 (TGFbeta2) reverses the inhibitory effects of fibrin sealant on cutaneous wound repair in the pig[J]. Wound Repair Regen, 2002, 10(4): 252-258.
[15]CHEN H C, YEN C I, YANG S Y, et al. Comparison of steroid and botulinum toxin type A monotherapy with combination therapy for treating human hypertrophic scars in an animal model[J]. Plast Reconstr Surg, 2017, 140(1): 43e-49e. DOI:10.1097/PRS.0000000000003426.
[16]TAKAHASHI H, ARIMURA Y, OKAHARA S, et al. A randomized controlled trial of endoscopic steroid injection for prophylaxis of esophageal stenoses after extensive endoscopic submucosal dissection[J]. BMC Gastroenterol, 2015, 15:1.DOI:10.1186/s12876-014-0226-6.

Memo

Memo:
-
Last Update: 2018-06-14