Fig. 2.

 Endoscopic appearance of hybrid therapy using locoregional steroid injection and polyglycolic acid (PGA) sheets with fibrin glue. Subtotal circumferential esophageal neoplasia was observed by chromoendoscopy with iodine staining (a), and circumferential endoscopic submucosal dissection (ESD) was performed (b). A steroid solution was carefully injected into the residual superficial submucosal layer (c). Pieces of PGA sheets were used to fill the mucosal defect using biopsy forceps. Subsequently, fibrin glue was applied to the PGA sheets (d). The PGA sheets remained in place upon observation on day 1 post-ESD (e). Endoscopic view showing that the ESD-induced ulceration improved without stricture and that a conventional upper gastrointestinal endoscope could be passed through the treatment site (f).