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Journal of Gastrointestinal & Digestive System | ISSN: 2161-069X | Volume 8
Clinical Gastroenterology and Hepatology
14
th
International Conference on
August 29-30, 2018 | Toronto, Canada
The mucosal loss is the critical mechanism of esophageal stricture after mucosal resection: A pilot
experiment in a Porcine Model
Bingrong Liu
and
Saif Ullah
The First Affiliated Hospital of Zhengzhou University, China
Background and Aim: Esophageal stricture is a major complication of large area endoscopic mucosal resection (EMR) or endoscopic
submucosal dissection (ESD). To date, the critical mechanism of esophageal stricture has not been fully elucidated. Here, we designed
this experiment to explore the role of mucosal loss in esophageal stricture after mucosal resection in a porcine model.
Material and Methods: Twelve swine were used for this study and randomly divided into two groups. Firstly, in all the swine, two
submucosal tunnels weremade of 5 cm in length and 1/3rd in width on the anterior and posterior wall of the esophageal circumference.
After that, the covered mucosa was resected along the lateral edges of the tunnel in the group 1. The meanwhile covered mucosa was
incised on the midline of the tunnels in the group 2. The process of stricture formation was evaluated by endoscopy after one, two and
four weeks respectively. Anatomical and histological examinations were performed after euthanasia.
Result: Ulcer formation was observed on endoscopy after one week. Group 1(mucosa resected) developed mild to severe esophageal
stricture with dysphagia and weight loss, whereas no esophageal stricture was evident in the ones of group 2 (mucosa incised) after
two and four weeks respectively. Macroscopic appearance showed severe esophageal stricture and shortening of the esophagus in
the group 1 while no evident esophageal stricture and shortened esophagus was found in the group 2. Inflammations and fibrous
hyperplasia of the submucosal layer were observed in both groups, on histological examination.
Conclusion: The loss of esophageal mucosa might be the crucial factor for esophageal stricture after mucosal resection. Fibrosis
followed by inflammation may slightly attribute toward esophageal stricture formation but is not the main mechanism of the post-
resection stricture. These results have significance for developing a suitable treatment for esophageal stricture.
karypton@hotmail.comJ Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C6-080