Yang Kai, Ling Christopher, Yuan Tianwen, Zhu Yueqi, Cheng Yingsheng, Cui Wenguo
Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yi Shan Road, Shanghai 200233, China.
Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute, Soochow University, 708 Renmin Road, Suzhou 215006, China.
Polymers (Basel). 2016 Apr 26;8(5):158. doi: 10.3390/polym8050158.
Esophageal stent insertion has been used as a well-accepted and effective alternative to manage and improve the quality of life for patients diagnosed with esophageal diseases and disorders. Current stents are either permanent or temporary and are fabricated from either metal or plastic. The partially covered self-expanding metal stent (SEMS) has a firm anchoring effect and prevent stent migration, however, the hyperplastic tissue reaction cause stent restenosis and make it difficult to remove. A fully covered SEMS and self-expanding plastic stent (SEPS) reduced reactive hyperplasia but has a high migration rate. The main advantage that polymeric biodegradable stents (BDSs) have over metal or plastic stents is that removal is not require and reduce the need for repeated stent insertion. But the slightly lower radial force of BDS may be its main shortcoming and a post-implant problem. Thus, strengthening support of BDS is a content of the research in the future. BDSs are often temporarily effective in esophageal stricture to relieve dysphagia. In the future, it can be expect that biodegradable drug-eluting stents (DES) will be available to treat benign esophageal stricture, perforations or leaks with additional use as palliative modalities for treating malignant esophageal stricture, as the bridge to surgery or to maintain luminal patency during neoadjuvant chemoradiation.
食管支架置入术已被用作一种广泛接受且有效的替代方法，用于管理和改善被诊断患有食管疾病和病症的患者的生活质量。目前的支架要么是永久性的，要么是临时性的，由金属或塑料制成。部分覆膜自膨式金属支架（SEMS）具有牢固的锚定作用，可防止支架移位，然而，增生性组织反应会导致支架再狭窄，并且难以取出。完全覆膜SEMS和自膨式塑料支架（SEPS）可减少反应性增生，但移位率较高。聚合物可生物降解支架（BDS）相对于金属或塑料支架的主要优点是无需取出，减少了重复置入支架的需求。但BDS的径向力略低可能是其主要缺点以及植入后的一个问题。因此，加强BDS的支撑是未来研究的一个内容。BDS在食管狭窄中通常能暂时有效地缓解吞咽困难。未来，可以预期可生物降解药物洗脱支架（DES）将可用于治疗良性食管狭窄、穿孔或渗漏，另外还可作为治疗恶性食管狭窄的姑息治疗方式、作为手术的桥梁或在新辅助放化疗期间维持管腔通畅。
