- 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.
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| 5. | 中华医学会小儿外科学分会普胸外科学组, 中国医师协会小儿外科医师分会心胸外科专委会. 儿童食管狭窄外科处理策略中国专家共识(2023版). 中华小儿外科杂志, 2023, 44(9): 774-783. |
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- 1. 柴宁莉, 李隆松, 邹家乐. 中国食管良恶性狭窄内镜下防治专家共识意见(2020, 北京). 中华胃肠内镜电子杂志, 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. 中华医学会小儿外科学分会普胸外科学组, 中国医师协会小儿外科医师分会心胸外科专委会. 儿童食管狭窄外科处理策略中国专家共识(2023版). 中华小儿外科杂志, 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. 陈功, 郑珊. 儿童食管狭窄的病因及诊治进展. 临床小儿外科杂志, 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. 杨立宝, 陈桂, 关静, 等. 生物可降解材料及其在生物医学上的应用. 新材料产业, 2018(12): 38-42.
- 24. 杨健, 孟礼飞, 谢晓, 等. 新型可降解支架治疗食管吻合口瘘的疗效分析. 现代生物医学进展, 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. Hänzi 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.
- 27. Bowen PK, Shearier ER, Zhao S, et al. Biodegradable metals for cardiovascular stents: From clinical concerns to recent Zn-alloys. Adv Healthc Mater, 2016, 5(10): 1121-1140.
- 28. Sun Y, Wu H, Wang W, et al. Translational status of biomedical Mg devices in China. Bioact Mater, 201, 4: 358-365.
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