Discussion
oesophageal perforation, bleeding, fibrosis, postoperative stricture
OESOPHAGEAL PERFORATION, BLEEDING, INFILTRATION, ADVERSE EVENTS, GASTROINTESTINAL BLEEDING, ULCERS, FIBROSIS, ESOPHAGEAL STRICTURES, OESOPHAGEAL STRICTURE, STRICTURE, ESOPHAGEAL NEOPLASMS, POSTOPERATIVE STRICTURE
In this multicentre, randomized, single-blind trial, we validated the potential of our novel protective gel as an effective and safe therapeutic agent for artificial wounds after oesophageal ESD. The healing rates of ulcers treated with this protective gel were much higher than those observed in the control group. Patients treated with the gel also had less severe wounds as determined by repeat endoscopy. Additionally, we observed no severe adverse events related to gel application that were reported during the 1-month follow-up. Therefore, our findings suggest that this kind of protective gel should be assessed as a potential treatment for patients receiving oesophageal ESD.ESD has enabled the en bloc resection of large-sized superficial oesophageal neoplasms, but it carries the risk of causing oesophageal stricture, bleeding, and perforationDuring the wound healing process, the infiltration of inflammatory cells, excessive collagen formation, and disorganized fibrosis might play a role in stricture formationCurrently, steroid administration and repeated endoscopic balloon dilatation are common interventions for preventing oesophageal strictures. However, it was reported that intralesional steroid injections could inhibit the healing process and cause oesophageal perforation and gastrointestinal bleeding. Systemic administration increases the risk of immunosuppression and osteoporosisAs mentioned above, advanced strategies such as cell sheets or mineral sheets have been proposed to protect wounds. However, some of them are time-consuming, while others require high technical expertiseAdmittedly, there are some limitations in this study. First, most of the former studies have indicated that postoperative stricture formed after 14 days