Stenosis prevention using autologous cell transplant for refractory stricture after esophageal ESD

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K09473
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Gastroenterology
• Research Institution: Tohoku University
• Principal Investigator: Sakurai Tadashi 東北大学, 医学系研究科, 非常勤講師 (40451570)
• Co-Investigator(Kenkyū-buntansha): 亀井 尚 東北大学, 医学系研究科, 教授 (10436115) ; 佐藤 千晃 東北大学, 大学病院, 助教 (60646800) ; 丸山 祥太 東北大学, 大学病院, 医員 (90746348) ; 谷山 裕亮 東北大学, 大学病院, 助教 (00622987)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: ESD後難治性食道狭窄 / 自家細胞移植 / 生体吸収ステント

Outline of Final Research Achievements

To prevent the refractory esophageal stricture after endoscopic submucosal dissection (ESD), we investigated the effects of bioabsorbable stent placement, autologous cell transplantation, and a combination of both methods. Stenting alone could delay the onset of stenosis, but no stenosis-preventing effect was observed. In addition, it was found that ingenuity such as sutures and clips was necessary for long-term placement of the stent at the mucosal resection site. Although autologous cell transplantation had some effect of accelerating epithelialization, it did not lead to stenosis prevention. Even when the both methods were combined, the fixation and placement of the stent were not stable, and no clear stenosis-preventing effect was observed. In the future, it is necessary to devise a method of fixing the stent and confirm the effect.

Free Research Field

消化器外科、消化器内視鏡

Academic Significance and Societal Importance of the Research Achievements

今回の検討では、ESD後の難治性狭窄の予防法の確立には至らなかったが、今後の課題が明らかとなった。これらの課題を解決し、狭窄予防法が確立されれば、これまでESD適応外とされてきた全周性病変や長径が大きい病変もESDで治癒可能となる。手術をはじめとする侵襲の高い治療法を回避し、ESDを行うことで患者さんのQOLの維持、早期の社会復帰が可能となるため、その意義は大きい。