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一种新型经内镜全覆膜食管自膨式金属支架的临床可行性:体内动物研究。

Clinical feasibility of a new through-the-scope fully covered esophageal self-expandable metallic stent: an in vivo animal study.

机构信息

Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.

出版信息

Dig Endosc. 2014 Jan;26(1):32-6. doi: 10.1111/den.12056. Epub 2013 Mar 31.

Abstract

BACKGROUND

Most delivery devices used for esophageal stents for obstructing esophageal cancer have a diameter of 5-8 mm, a size that is too large to pass through the endoscopic working channel. The conventional esophageal stent requires multiple endoscopic procedures for implantation. The purpose of the present study was to evaluate the clinical feasibility of a newly developed fully covered, self-expanding, through-the-scope (TTS) esophageal stent in a porcine model.

METHODS

Eight mini pigs were used. Each animal underwent placement of a fully covered TTS stent (Hanarostent® Esophagus TTS) and the upper part of the stent was fixed by suturing with nylon. Fluoroscopy was carried out every week to assess migration of the stent. Follow-up endoscopy was done every month for 3 months to evaluate the status of the membrane, stent mesh, grade of tissue hyperplasia, and mucosal changes at both ends of the stent.

RESULTS

All stents were successfully and easily deployed, and were placed without any distortion in the stent or without rupture of the membrane. In two cases, stent migration was observed after 8 weeks. No case of membrane disruption, stent mesh disruption or tissue hyperplasia at either end of the stent was found at the completion of the study.

CONCLUSION

Our findings indicate that the new fully covered self-expanding TTS esophageal stent is easy and simple to implant, and no significant distortion of mesh or disruption of membrane was observed.

摘要

背景

大多数用于治疗食管癌的食管支架输送装置的直径为 5-8mm,尺寸过大,无法通过内镜工作通道。传统的食管支架需要多次内镜手术植入。本研究旨在评估一种新型完全覆膜、自膨式、经内镜(TTS)食管支架在猪模型中的临床可行性。

方法

8 只小型猪被用于本研究。每只动物均被植入完全覆膜 TTS 支架(Hanarostent® Esophagus TTS),支架的上半部分通过尼龙缝线固定。每周进行一次透视检查,以评估支架的迁移情况。在接下来的 3 个月中,每月进行一次内镜随访,以评估膜、支架网、组织增生程度和支架两端的黏膜变化情况。

结果

所有支架均成功且易于部署,且在支架未发生扭曲或膜未破裂的情况下进行放置。8 周后观察到 2 例支架迁移。研究结束时,未发现膜破裂、支架网破裂或支架两端组织增生。

结论

我们的研究结果表明,新型完全覆膜自膨式 TTS 食管支架易于植入,且未观察到明显的网眼变形或膜破裂。

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