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Esophageal biodegradable stents

Daisy Walter, Maarten W van den Berg, Meike M Hirdes, Frank P Vleggaar, Alessandro Repici, Pierre H Deprez, Bartolomé L Viedma, Laurence B Lovat, Bas L Weusten, Raf Bisschops, Rehan Haidry, Elisa Ferrara, Keith J Sanborn, Erin E O'Leary, Jeanin E van Hooft, Peter D Siersema
BACKGROUND:  Dilation is the standard of care for recurrent benign esophageal strictures (BES). Biodegradable stents may prolong the effect of dilation and reduce recurrences. Efficacy and safety of dilation and biodegradable stent placement early in the treatment algorithm of recurrent BES were compared. METHODS:  This multicenter, randomized study enrolled patients with BES treated with previous dilations to ≥ 16 mm. The primary end point was number of repeat endoscopic dilations for recurrent stricture within 3 and 6 months...
June 8, 2018: Endoscopy
Abed Al Lehibi, Areej Al Balkhi, Abdullah Al Mtawa, Nawaf Al Otaibi
Background and aims:  Postoperative leak is one of the most feared complications after bariatric surgery. Endoscopic stenting is used to manage leaks by decreasing the gastrointestinal intraluminal pressure. The main advantage of endoscopic management is providing healing while still allowing for oral nutrition. However, limited literature exists on whether biodegradable stents can be used to control leaks when conventional metallic stents fail. Methods:  Our series consists of four patients who were found to have a leak as a complication of bariatric surgery...
June 2018: Endoscopy International Open
Yang Cao, Yadong Feng, Chunhua Jiao, Ruihua Shi
<b>Objective:</b> To evaluate the feasibility of two types of segmented biodegradable esophageal stents in treatment of refractory benign esophagus strictures. <b>Methods:</b> 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. <b>Results:</b> All animals kept good general conditions; no death, decreased food intake, weight loss and malnutrition were observed...
May 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Michael Drepper, Philippe Bichard, Jean-Louis Frossard
Bening strictures of the esophagus are a frequently encountered problem in endoscopy. Dilation by Savary-Gilliard dilators or balloon dilators is the first line treatment and relieves dysphagia in about 75 % of cases. Complex strictures are at higher risk of treatment failure than simple ones and are considered as refractory after repetitive unsuccessful dilations. Adjunction of locally injected corticoids favors outcome in strictures of peptic origin. Further treatment options of refractory strictures are endoscopic incision therapy in short ones and temporary self expandable metallic (SEMS), plastic (SEPS) or biodegradable stent insertion in complex ones...
August 31, 2016: Revue Médicale Suisse
Koichiro Kawaguchi, Hiroki Kurumi, Yohei Takeda, Kazuo Yashima, Hajime Isomoto
Endoscopic resection of early esophageal cancer has a high therapeutic effect while being minimally invasive. Especially, the establishment of the endoscopic submucosal dissection (ESD) procedure has made it possible to resect large lesions in an en-bloc manner. As a result, accurate pathology evaluation became possible, and the risk of local recurrence was extremely low. On the other hand, esophageal strictures after endoscopic treatment of an extensive circumferential lesion are a potential problem. Previously, for the prevention and treatment of esophageal strictures, patients had to undergo painful endoscopic balloon dilation (EBD) many times...
April 2017: Annals of Translational Medicine
Óscar Nogales, Ana Clemente, Aránzazu Caballero-Marcos, Javier García-Lledó, Leticia Pérez-Carazo, Beatriz Merino, María López-Ibáñez, María Dolores Pérez Valderas, Rafael Bañares, Cecilia González-Asanza
INTRODUCTION: Benign esophageal strictures are relatively frequent and can severely affect the quality of life of a patient. Stenting has been proposed for the treatment of refractory cases. Lesions affecting the cervical esophagus are more difficult to treat, and the placement of stents in this location has traditionally been restricted due to potential adverse events. The aim of this study was to describe the efficacy and safety of endoscopic stenting in the management of refractory benign cervical esophageal strictures (RBCES) in a single-center cohort study...
July 2017: Revista Española de Enfermedades Digestivas
Rakesh Kochhar, Jayanta Samanta, Jahangeer Basha, Abhai Verma, Gourdas Choudhuri, Sundeep Lakhtakia, D Nageshwar Reddy
Biodegradable (BD) stents have been used for the management of various esophageal strictures (ES) but the experience of its use in caustic strictures is limited. The present study, aimed at evaluating efficacy of BD stents for the treatment of refractory caustic-induced ES, was a retrospective multi-center study conducted at three tertiary care centers in India wherein adult patients with refractory caustic induced strictures underwent placement of a BD stent. Patients were followed up for immediate complications and long term outcome...
August 2017: Dysphagia
Yue-Qi Zhu, Kai Yang, Laura Edmonds, Li-Ming Wei, Reila Zheng, Ruo-Yu Cheng, Wen-Guo Cui, Ying-Sheng Cheng
BACKGROUND: We determined the feasibility of, and tissue response to silicone-covered biodegradable magnesium- and plastic-stent insertion into the esophagus in rabbits. METHODS: The mechanical compression-recovery characteristics and degradation behaviors of the magnesium stent were investigated in vitro. A total of 45 rabbits were randomly divided into a magnesium- (n = 15) and a plastic- (n = 15) stent group, and underwent stent insertion into the lower third of the esophagus under fluoroscopic guidance; a control group (n = 15) did not undergo the intervention...
January 2017: Therapeutic Advances in Gastroenterology
Ke-Da Shi, Feng Ji
Endoscopic submucosal dissection (ESD) of superficial esophageal cancer has been increasingly used as an alternative to surgery because it is minimally invasive and has a high rate of en bloc resection. However, a high rate of esophageal stricture is observed after ESD for large lesions, which can dramatically decrease the patient's quality of life. Stricture prevention is necessary to allow for endoscopic therapy to expand. We, herein, review the most recent evidence and discuss the role of the metallic self-expandable stent and the biodegradable stent in esophageal stricture prevention...
February 14, 2017: World Journal of Gastroenterology: WJG
Tomonori Yano, Yusuke Yoda, Shogo Nomura, Kayo Toyosaki, Hiromi Hasegawa, Hiroyuki Ono, Masaki Tanaka, Hiroyuki Morimoto, Takahiro Horimatsu, Satoru Nonaka, Kazuhiro Kaneko, Akihiro Sato
BACKGROUND AND AIMS: Biodegradable stents are reportedly effective for refractory benign esophageal strictures; however, little is known about their use in patients with refractory stricture after endoscopic submucosal dissection (ESD) or chemoradiotherapy (CRT) for esophageal cancer. This study aimed to evaluate the effectiveness of biodegradable stents for these patients. METHODS: Patients with refractory benign esophageal stricture with a dysphagia score (DS) of 2 or worse and for whom the passage of a standard size endoscope was not possible were eligible...
January 27, 2017: Gastrointestinal Endoscopy
Fernando Alberca de Las Parras, María Navalón Rubio, Juan Egea Valenzuela
INTRODUCTION: Refractory esophageal stenosis (RES) is a major health problem in the pediatric population. Several techniques such as stent placement or C-mitomycin (CM) have been described as alternative treatments. We present our experience with both techniques, in our case with biodegradable stents (BS) and sometimes the association with stents and CM. MATERIAL AND METHODS: Six patients have been included: 2 post-operative fistulas in patients with type I esophageal atresia; 1 operated atresia without fistula; and 3 caustic strictures...
October 2016: Revista Española de Enfermedades Digestivas
Dimitrios E Sigounas, Sandeep Siddhi, John N Plevris
BACKGROUND AND STUDY AIMS: Biodegradable (BD) esophageal stents were recently developed mainly for refractory benign strictures, but experience and available literature are limited. PATIENTS AND METHODS: This was a retrospective observational study. All patients who had BD stents inserted due to refractory benign esophageal strictures or malignant strictures, or were awaiting radical radiotherapy/chemotherapy or neo-adjuvant therapy and esophagectomy between March 2011 and July 2015 were included...
June 2016: Endoscopy International Open
Hang Zhao, Yongxin Zhou, Jing Feng, Wenli Wang, Yunqing Mei
To analyze the efficacy and safety of benign esophageal disease used biodegradable (BD) stent or metal stent. The English literatures of benign esophageal disease that were treated by biodegradable or metal stents implantation were retrieved and summarized. In all 323 benign esophageal disease, the most common etiologies were benign refractory stricture, surgical anastomotic stricture and esophageal fistula/leak/perforation, but the main characteristics between the two groups were not significantly different...
February 2016: Indian Journal of Surgery
Jin Liu, Liang Shang, Jiyong Liu, Chengyong Qin
Biodegradable esophageal stents eliminate stent retrieval, but usually induce hyperplasia. This study investigated the properties of a novel biodegradable stent in vitro and in vivo. The degradation of the novel stent was observed in phosphate buffered saline (PBS) for 8 weeks. The radial forces, pH values, morphology, and retention rate of the intrinsic viscosity (R[η]) of the new biodegradable stent were all evaluated. In vitro, the pH values remained constant for 4 weeks and declined from weeks 4 to 8. The biodegradable threads degraded and ruptured at 6 weeks...
2016: American Journal of Translational Research
Yadong Feng, Chunhua Jiao, Yang Cao, Ye Zhao, Yanfang Chen, Lin Fang, Ruihua Shi
Aims. This study was to compare the degradation, complications, and tissue reactions of two segmented biodegradable esophageal stents in a porcine model. Methods. Uncovered biodegradable segmented stents and fully covered biodegradable segmented stents (FCBDS) were transplanted into the porcine esophagus lumen. Data on biodegradation, complications, and tissue reactions were collected and compared. Results. All animals kept good general conditions. No severe complications and stents migration occurred. Stents degradation commenced at week 3...
2016: Gastroenterology Research and Practice
Alessandro Repici, Aaron J Small, Aaron Mendelson, Manol Jovani, Loredana Correale, Cesare Hassan, Lorenzo Ridola, Andrea Anderloni, Elisa Chiara Ferrara, Michael L Kochman
BACKGROUND AND AIMS: The natural history of refractory benign esophageal strictures (RBES) is unclear, and surgery or percutaneous endoscopic gastrostomy (PEG) may be the only viable long-term options. The aim of the present study was to assess the long-term outcomes of patients with RBES. METHODS: Clinical data of consecutive patients with RBES treated in the previous 15 years in 2 tertiary-care referral academic centers with specialized interest in esophageal stricture management were retrospectively analyzed...
August 2016: Gastrointestinal Endoscopy
Toufic Kachaamy, Rahul Pannala
Esophageal stents are devices used to alleviate dysphagia and treat leaks and perforations. Successful esophageal stenting requires definition of the abnormal anatomy such as stricture length or location of the leak, proper stent selection and deployment. This requires detailed knowledge of characteristics of the currently available stents. Self-expanding metal stents whether fully or partially covered have become the mainstay of treatment of esophageal cancer-related dysphagia as they provide quick relief of symptoms and have a favorable safety and efficacy profile, compared to other modalities such as radiation, laser, and argon plasma coagulation...
June 2016: Minerva Gastroenterologica e Dietologica
Julia Wang, Jonah A Kaplan, Yolonda L Colson, Mark W Grinstaff
The concept of using crack propagation in polymeric materials to control drug release and its first demonstration are reported. The composite drug delivery system consists of highly-textured superhydrophobic electrosprayed microparticle coatings, composed of biodegradable and biocompatible polymers poly(caprolactone) and poly(glycerol monostearate carbonate-co-caprolactone), and a cellulose/polyester core. The release of entrapped agents is controlled by the magnitude of applied strain, resulting in a graded response from water infiltration through the propagating patterned cracks in the coating...
February 18, 2016: Angewandte Chemie
Lorenzo Fuccio, Cesare Hassan, Leonardo Frazzoni, Rossella Miglio, Alessandro Repici
BACKGROUND AND AIMS: The management of refractory benign esophageal strictures (RBESs) is challenging. Stent placement has been proposed as a possible rescue strategy. We performed a systematic review and meta-analysis to examine the efficacy of this strategy in the long-term resolution of dysphagia. METHODS: PubMed, SCOPUS, and Google Scholar were searched (up to January 2015). Studies recruiting adults with RBES treated with stent placement were eligible. The success, adverse event, and migration rates were pooled by means of a random-effect model to obtain odds with a 95 % confidence interval (CI)...
February 2016: Endoscopy
Mahesh Kumar Goenka, Usha Goenka
Perforations, leaks and fistula involving gastrointestinal (GI) tract are increasing encountered in clinical practice. There is a changing paradigm for their management with surgical approach being replaced by conservative approach including endoscopic therapy. Clips (through the scope and over the scope) and covered stent are front runners for endotherapy for GI leaks and fistula. Over the scope clips introduced recently, can treat larger defects compared to through the scope clips. Covered stents are suited for larger defects and those associated with luminal narrowing...
June 25, 2015: World Journal of Gastrointestinal Endoscopy
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