Bao Yuchen, Li Zhenguang, Li Yingze, Chen Tao, Cheng Yu, Xu Meidong
Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Institute for Translational Nanomedicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Endoscopy Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Front Bioeng Biotechnol. 2021 Dec 22;9:792929. doi: 10.3389/fbioe.2021.792929. eCollection 2021.
Esophageal stricture commonly occurs in patients that have suffered from endoscopic submucosal dissection (ESD), and it makes swallowing difficult for patients, significantly reducing their life qualities. So far, the prevention strategies applied in clinical practice for post-ESD esophageal stricture usually bring various inevitable complications, which drastically counteract their effectiveness. Nowadays, with the widespread investigation and application of biomedical materials, lots of novel approaches have been devised in terms of the prevention of esophageal stricture. Biomedical polymers and biomedical-derived materials are the most used biomedical materials to prevent esophageal stricture after ESD. Both of biomedical polymers and biomedical-derived materials possess great physicochemical properties such as biocompatibility and biodegradability. Moreover, some biomedical polymers can be used as scaffolds to promote cell growth, and biomedical-derived materials have biological functions similar to natural organisms, so they are important in tissue engineering. In this review, we have summarized the current approaches for preventing esophageal stricture and put emphasis on the discussion of the roles biomedical polymers and biomedical-derived materials acted in esophageal stricture prevention. Meanwhile, we proposed several potential methods that may be highly rational and feasible in esophageal stricture prevention based on other researches associated with biomedical materials. This review is expected to offer a significant inspiration from biomedical materials to explore more effective, safer, and more economical strategies to manage post-ESD esophageal stricture.
食管狭窄常见于接受内镜黏膜下剥离术（ESD）的患者中，这会使患者吞咽困难，严重降低其生活质量。到目前为止，临床实践中用于预防ESD后食管狭窄的策略通常会带来各种不可避免的并发症，这大大抵消了它们的有效性。如今，随着生物医学材料的广泛研究和应用，在食管狭窄的预防方面已经设计出许多新方法。生物医学聚合物和生物医学衍生材料是ESD后预防食管狭窄最常用的生物医学材料。生物医学聚合物和生物医学衍生材料都具有良好的物理化学性质，如生物相容性和生物降解性。此外，一些生物医学聚合物可用作支架以促进细胞生长，生物医学衍生材料具有与天然生物体相似的生物学功能，因此它们在组织工程中很重要。在这篇综述中，我们总结了目前预防食管狭窄的方法，并重点讨论了生物医学聚合物和生物医学衍生材料在预防食管狭窄中所起的作用。同时，我们基于与生物医学材料相关的其他研究提出了几种在食管狭窄预防中可能高度合理且可行的潜在方法。这篇综述有望从生物医学材料方面提供重要启示，以探索更有效、更安全和更经济的策略来处理ESD后食管狭窄。
