Cao Yang, Feng Yadong, Jiao Chunhua, Shi Ruihua
Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing 210009, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2017 May 25;46(6):649-655. doi: 10.3785/j.issn.1008-9292.2017.12.12.
To evaluate the feasibility of two types of segmented biodegradable esophageal stents in treatment of refractory benign esophagus strictures. Uncovered biodegradable segmented stent and fully-covered biodegradable segmented stent were implanted into the porcine esophagus (6 for each). Data on biodegradation, complications, and tissue reactions were compared between two groups. All animals kept good general conditions; no death, decreased food intake, weight loss and malnutrition were observed. No perforation, ulcer, hemorrhage, stent migration and severe complications occurred. Stents degradation commenced at week 3. Stents structure breakage and complete stents absorption occurred at week 7-8 and week 9-10 in uncovered stents. While in fully-covered stents, stents structure breakage and complete stents absorption occurred at week 8-9 and week 10-11. Hyperplasia was prominent at week 1-3 and ameliorated at week 6 after stent implantation. A longer degradation period was present in fully-covered stents than in uncovered stents, while fully-covered stents induced tissue reactions at early stage were mild. The application of biodegradable esophageal stents with a segmented trunk in refractory benign esophagus strictures worth further investigation. The fully-covered stent has longer degradation period, which may be more suitable for clinical use.
评估两种分段式可降解食管支架治疗难治性良性食管狭窄的可行性。将裸化可降解分段支架和全覆膜可降解分段支架植入猪食管(每组6个)。比较两组之间关于生物降解、并发症和组织反应的数据。所有动物总体状况良好;未观察到死亡、食物摄入量减少、体重减轻和营养不良。未发生穿孔、溃疡、出血、支架移位及严重并发症。支架在第3周开始降解。裸化支架在第7 - 8周出现支架结构破坏,第9 - 10周完全吸收。而全覆膜支架在第8 - 9周出现支架结构破坏,第10 - 11周完全吸收。支架植入后第1 - 3周增生明显,第6周改善。全覆膜支架的降解期比裸化支架长,且全覆膜支架早期诱导的组织反应较轻。带分段主体的可降解食管支架在难治性良性食管狭窄中的应用值得进一步研究。全覆膜支架降解期更长,可能更适合临床应用。