Use of rebamipide solution as a submucosal injection material to prevent esophageal stricture after endoscopic submucosal dissection: Animal study.

Background and study aims: It is desirable to develop a safe, cost-effective, and easy approach to prevent strictures after esophageal endoscopic submucosal dissection (ESD). We explored use of a novel rebamipide solution, an anti-ulcer drug, as a submucosal injection material for preventing esophageal stricture after ESD. Methods: In 15 swine, two half-circumferential ESDs were performed at the proximal and distal ends of the middle thoracic esophagus using 2% rebamipide solution or saline (control) as submucosal injection material. Five swine were sacrificed on postoperative days (PODs) 7, 14, and 21, respectively. Follow-up endoscopy was performed weekly until sacrifice. ESD-related outcomes, degree of stricture, and histological characteristics were evaluated. Results: ESD-related outcomes were similar in both groups, with all post-ESD ulcers epithelialized by POD 14. Mean mucosal constriction rate in the rebamipide and control groups on PODs 14 and 21 were 19.1 ± 7.2% vs. 21.0 ± 6.4% ( Conclusions: The rebamipide solution showed no statistically significant benefit in preventing post-ESD stricture. However, given the small sample size of this study, further studies are needed to clarify its potential role.