- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing 210019, Jiangsu, P. R. China;
WU Kaihong,
Email: pumcwu@sina.com
[Abstract]Esophageal stricture is a common esophageal lesion in adults and children, and endoscopic dilatation is currently the standard treatment. However, high recurrence rate and frequent dilations have become a major problem in patients. Esophageal stents provide sustained dilation therapy but can lead to serious complications such as displacement, perforation, and bleeding, necessitating removal. Biodegradable stents, with the advantage of both dilation and self-degradation, are promising potential solutions to this problem. Currently, biodegradable materials are mainly categorized into metals and polymers, leading to the development of magnesium alloy esophageal stents and polymer esophageal stents. Among polymer stents, PLLA stents and SX-ELLA stents have been put into clinical application. In recent years, with the advancement of 3D bioprinting technology, the personalized fabrication of biodegradable stents has become feasible. In this paper, we will outline the current research status and progress of biodegradable magnesium alloy stents and polymer stents, introduce the new process of constructing esophageal stents by 3D bioprinting technology, focus on the clinical research of SX-ELLA stents in pediatric and adult patients. We will also analyze the existing problems with biodegradable stents and the directions for future development.
Copyright ? the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved
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- 1. 柴寧莉, 李隆松, 鄒家樂. 中國食管良惡性狹窄內鏡下防治專家共識意見(2020, 北京). 中華胃腸內鏡電子雜志, 2020, 7(4): 165-175.
- 2. Spaander MCW, van der Bogt RD, Baron TH, et al. Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2021. Endoscopy, 2021, 53(7): 751-762.
- 3. Tandon S, Burnand KM, De Coppi P, et al. Self-expanding esophageal stents for the management of benign refractory esophageal strictures in children: A systematic review and review of outcomes at a single center. J Pediatr Surg, 2019, 54(12): 2479-2486.
- 4. Shahein AR, Krasaelap A, Ng K, et al. Esophageal dilation in children: A state of the art review. J Pediatr Gastroenterol Nutr, 2023, 76(1): 1-8.
- 5. 中華醫學會小兒外科學分會普胸外科學組, 中國醫師協會小兒外科醫師分會心胸外科專委會. 兒童食管狹窄外科處理策略中國專家共識(2023版). 中華小兒外科雜志, 2023, 44(9): 774-783.
- 6. Ruigómez A, García Rodríguez LA, Wallander MA, et al. Esophageal stricture: Incidence, treatment patterns, and recurrence rate. Am J Gastroenterol, 2006, 101(12): 2685-2692.
- 7. McCain S, McCain S, Quinn B, et al. The role of biodegradable stents in the management of benign and malignant oesophageal strictures: A cohort study. Surgeon, 2016, 14(6): 322-326.
- 8. 陳功, 鄭珊. 兒童食管狹窄的病因及診治進展. 臨床小兒外科雜志, 2019, 18(6): 437-441.
- 9. Fugazza A, Repici A. Endoscopic management of refractory benign esophageal strictures. Dysphagia, 2021, 36(3): 504-516.
- 10. Sami SS, Haboubi HN, Ang Y, et al. UK guidelines on oesophageal dilatation in clinical practice. Gut, 2018, 67(6): 1000-1023.
- 11. Desai M, Hamade N, Sharma P. Management of peptic strictures. Am J Gastroenterol, 2020, 115(7): 967-970.
- 12. de Wijkerslooth LR, Vleggaar FP, Siersema PD. Endoscopic management of difficult or recurrent esophageal strictures. Am J Gastroenterol, 2011, 106(12): 2080-2091.
- 13. Alwan M, Giddings CE. Self-dilatation of benign oesophageal strictures: A literature review. ANZ J Surg, 2021, 91(7-8): 1385-1389.
- 14. Yang F, Hu Y, Shi Z, et al. The occurrence and development mechanisms of esophageal stricture: State of the art review. J Transl Med, 2024, 22(1): 123.
- 15. Repici A, Small AJ, Mendelson A, et al. Natural history and management of refractory benign esophageal strictures. Gastrointest Endosc, 2016, 84(2): 222-228.
- 16. Imaz-Iglesia I, García-Pérez S, Nachtnebel A, et al. Biodegradable stents for the treatment of refractory or recurrent benign esophageal stenosis. Expert Rev Med Devices, 2016, 13(6): 583-599.
- 17. Fuccio L, Hassan C, Frazzoni L, et al. Clinical outcomes following stent placement in refractory benign esophageal stricture: A systematic review and meta-analysis. Endoscopy, 2016, 48(2): 141-148.
- 18. Li L, Xu N, Wang P, et al. A novel self-inflatable balloon for treating refractory benign esophageal strictures: A prospective, single-arm, multicenter study. Int J Surg, 2024, 110(4): 2055-2064.
- 19. Kang Y. A review of self-expanding esophageal stents for the palliation therapy of inoperable esophageal malignancies. Biomed Res Int, 2019 Apr 4: 2019: 9265017.
- 20. Frimberger E. Expanding spiral--A new type of prosthesis for the palliative treatment of malignant esophageal stenoses. Endoscopy, 1983, 15 Suppl 1: 213-214.
- 21. Canena JM, Liberato MJ, Rio-Tinto RA, et al. A comparison of the temporary placement of 3 different self-expanding stents for the treatment of refractory benign esophageal strictures: A prospective multicentre study. BMC Gastroenterol, 2012, 12: 70.
- 22. Zhu Y, Yang K, Cheng R, et al. The current status of biodegradable stent to treat benign luminal disease(Review). Mater Today, 2017, 20(9): 516-529.
- 23. 楊立寶, 陳桂, 關靜, 等. 生物可降解材料及其在生物醫學上的應用. 新材料產業, 2018(12): 38-42.
- 24. 楊健, 孟禮飛, 謝曉, 等. 新型可降解支架治療食管吻合口瘺的療效分析. 現代生物醫學進展, 2018, 18(11): 2043-2046.
- 25. Tie D, Guan R, Liu H, et al. In vivo degradability and biocompatibility of a rheo-formed Mg–Zn–Sr alloy for ureteral implantation. J Magnes Alloys, 2022, 10(6): 1631-1639.
- 26. H?nzi AC, Gerber I, Schinhammer M, et al. On the in vitro and in vivo degradation performance and biological response of new biodegradable Mg-Y-Zn alloys. Acta Biomater, 2010, 6(5): 1824-1833.
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