Tyč Daniel, Vaněčková Nina, Hanuš Josef, Selke Krulichová Iva
Department of Medical Biophysics, Charles University - Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czechia.
ELLA-CS, s.r.o., Hradec Kralove, Czechia.
Digestion. 2025 May 27:1-12. doi: 10.1159/000546377.
Refractory benign esophageal strictures (RBES) pose significant clinical challenges. Biodegradable (BD) stents have emerged as alternatives to traditional stenting methods, offering the possibility of reducing the need for multiple procedures. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of BD stents in the treatment of RBES.
The PubMed, Web of Science, Scopus, Cochrane, and Science Direct databases were searched according to the PRISMA statement. Studies that focused on the clinical outcomes of BD stents used in adult patients with RBES were included. Data on technical success and complication rates were analyzed using random-effects models. Efficacy data were analyzed using Kaplan-Meier analysis.
The review included 15 studies with 241 BD stent implantations. The technical success rates were consistently high in all studies. The median time to restenosis was 21 weeks, with survival rates of 38.4% at 26 weeks and 27.0% at 52 weeks. The rate of complications requiring intervention was relatively low, but significant hyperplasia and pain occurred in 16.4% and 8.8% of the cases, respectively. Significant heterogeneity was observed in hyperplasia-related outcomes, which required a detailed subgroup analysis to investigate the underlying causes.
BD stents provide acceptable results in terms of efficacy and safety for the treatment of RBES. However, the evidence is limited owing to the lack of randomized controlled trials and comparative studies. Future research should focus on these areas to strengthen the clinical evidence regarding BD stents.
难治性良性食管狭窄（RBES）带来了重大的临床挑战。可生物降解（BD）支架已成为传统支架置入方法的替代方案，为减少多次手术的需求提供了可能。本系统评价和荟萃分析旨在评估BD支架治疗RBES的疗效和安全性。
根据PRISMA声明检索PubMed、Web of Science、Scopus、Cochrane和Science Direct数据库。纳入关注BD支架在成年RBES患者中临床结局的研究。使用随机效应模型分析技术成功率和并发症发生率数据。使用Kaplan-Meier分析方法分析疗效数据。
该评价纳入了15项研究，共241例BD支架植入病例。所有研究的技术成功率均持续较高。再狭窄的中位时间为21周，26周时生存率为38.4%，52周时为27.0%。需要干预的并发症发生率相对较低，但分别有16.4%和8.8%的病例出现明显增生和疼痛。在增生相关结局方面观察到显著的异质性，这需要进行详细的亚组分析以探究潜在原因。
BD支架在治疗RBES的疗效和安全性方面提供了可接受的结果。然而，由于缺乏随机对照试验和比较研究，证据有限。未来的研究应聚焦于这些领域，以加强关于BD支架的临床证据。
