Shang Liang, Pei Qing-Shan, Xu Dan, Liu Ji-Yong, Liu Jin
Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China.
Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China.
Exp Ther Med. 2020 Jan;19(1):115-122. doi: 10.3892/etm.2019.8190. Epub 2019 Nov 12.
The radial force of esophageal stents may not completely change during extraction and therefore, the procedure of stent removal may cause tissue damage. The present study reports the manufacture of 2 novel detachable stents, which were designed to reduce tissue damage through their capacity to be taken or fall apart prior to removal and evaluated the supporting properties of these stents and the extent of local mucosal injury during their removal. The stents were manufactured by braiding, heat-setting, coating and connecting. The properties of the stents were evaluated by determining the following parameters: Expansion point, softening point, stent flexibility, radial compression ratio and radial force. A total of 18 rabbits with induced esophageal stricture were randomly assigned to 3 groups as follows: Detachable stent (DS) group, biodegradable stent (BS) group and control group. The stricture rate, complications, survival, degradation and stent removal were observed over 8 weeks. The stents of the DS and BS groups provided a similar supporting effect. The stricture rate, incidence of complications and survival were also similar between the 2 groups, while significant differences were noted between the DS and control groups and between the BS and control groups. In the BS group, the stents were degraded and moved to the stomach within 7 weeks (2 in 6 weeks and 3 in 7 weeks). The debris was extracted using biopsy forceps. In the DS group, all stents were easy to remove and 2 cases exhibited minor hemorrhage. In conclusion, the 2 types of novel detachable stent provided an equally efficient supporting effect and and may reduce the incidence of secondary injury during stent removal.
食管支架的径向力在取出过程中可能不会完全改变，因此，支架取出过程可能会导致组织损伤。本研究报告了两种新型可拆除支架的制造方法，其设计目的是通过在取出前能够拆解或自行脱落的能力来减少组织损伤，并评估了这些支架的支撑性能以及取出过程中局部黏膜损伤的程度。这些支架通过编织、热定型、涂层和连接等工艺制造而成。通过测定以下参数来评估支架的性能：扩张点、软化点、支架柔韧性、径向压缩率和径向力。总共18只诱导食管狭窄的兔子被随机分为以下3组：可拆除支架（DS）组、生物可降解支架（BS）组和对照组。在8周内观察狭窄率、并发症、存活率、降解情况和支架取出情况。DS组和BS组的支架提供了相似的支撑效果。两组之间的狭窄率、并发症发生率和存活率也相似，而DS组与对照组之间以及BS组与对照组之间存在显著差异。在BS组中，支架在7周内降解并移入胃内（6周内2个，7周内3个）。使用活检钳取出碎片。在DS组中，所有支架都易于取出，2例出现轻微出血。总之，这两种新型可拆除支架提供了同样有效的支撑效果，并且可能降低支架取出过程中二次损伤的发生率。
