Abstract
The application of metallic stents for benign stenosis is limited due to long-term complications. We report here the results of the implantation of a novel biodegradable poly-l-lactic acid (PLLA) esophageal stent in two patients with benign esophageal stenosis after endoscopic submucosal dissection (ESD). Case 1 was a 64-year-old man who received ESD for an early squamous esophageal cancer in the middle esophagus. The mucosal defect was seven-eighths of the circumference, and the distal margin of the resection scar formed the stenosis. After balloon dilatation, the PLLA esophageal stent was endoscopically placed; for 6 months, he has not experienced any symptoms of re-stenosis. Case 2 consisted of a 62-year-old man who developed an early squamous esophageal cancer in the middle esophagus. The lesion was resected by ESD, and the mucosal defect was seven-eighths of the circumference. The resection scar formed the stenosis, and the PLLA esophageal stent was endoscopically placed. He also has not experienced any symptoms of re-stenosis for 6 months. In conclusion, the PLLA esophageal stent provides a new possibility for the management of benign esophageal strictures after ESD. Due to the biodegradable features of this stent, longer term studies are necessary to investigate the relationship between the expected disappearance of the stent and the patency of the stricture.
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References
Holt AP, Patel M, Ahmed MM (2004) Palliation of patients with malignant gastroduodenal obstruction with self-expanding metallic stents: the treatment of choice? Gastrointest Endosc 60:1010–1017
Song HY, Do YS, Han YM, Sung KB, Choi EK, Sohn KH, Kim HR, Kim SH, Min YI (1994) Covered, expandable esophageal metallic stent tubes: experiences in 119 patients. Radiology 193:689–695
Song HY, Park SI, Do YS, Yoon HK, Sung KB, Sohn KH, Min YI (1997) Expandable metallic stent placement in patients with benign esophageal strictures: results of long-term follow-up. Radiology 203:131–136
Ackroyd R, Watson DI, Devitt PG, Jamieson GG (2001) Expandable metallic stents should not be used in the treatment of benign esophageal strictures. J Gastroenterol Hepatol 16:484–487
Evrard S, Le Moine O, Lazaraki G, Dormann A, El Nakadi I, Deviere J (2004) Self-expanding plastic stents for benign esophageal lesions. Gastrointest Endosc 60:894–900
Mercer CD, Hill LD (1986) Surgical management of peptic esophageal stricture. Twenty-year experience. J Thorac Cardiovasc Surg 91:371–378
Karas SP, Gravanis MB, Santoian EC, Robinson KA, Anderberg KA, King SB 3rd (1992) Coronary intimal proliferation after balloon injury and stenting in swine: an animal model of restenosis. J Am Coll Cardiol 20:467–474
Oyama T, Tomori A, Hotta K, Morita S, Kominato K, Tanaka M, Miyata Y (2005) Endoscopic submucosal dissection of early esophageal cancer. Clin Gastroenterol Hepatol 3:S67–S70
Kulkarni RK, Pani KC, Neuman C, Leonard F (1966) Polylactic acid for surgical implants. Arch Surg 93:839–843
Schakenraad JM, Dijkstra PJ (1991) Biocompatibility of poly (dl-lactic acid/glycine) copolymers. Clin Mater 7:253–269
Schakenraad JM, Hardonk MJ, Feijen J, Molenaar I, Nieuwenhuis P (1990) Enzymatic activity toward poly(l-lactic acid) implants. J Biomed Mater Res 24:529–545
Bostman OM (1991) Absorbable implants for the fixation of fractures. J Bone Joint Surg Am 73:148–153
Tamai H, Igaki K, Kyo E, Kosuga K, Kawashima A, Matsui S, Komori H, Tsuji T, Motohara S, Uehata H (2000) Initial and 6-month results of biodegradable poly-l-lactic acid coronary stents in humans. Circulation 102:399–404
Tsuji T, Tamai H, Igaki K, Kyo E, Kosuga K, Hata T, Okada M, Nakamura T, Komori H, Motohara S, Uehata H (2001) Biodegradable polymeric stents. Curr Interv Cardiol Rep 3:10–17
Vogt F, Stein A, Rettemeier G, Krott N, Hoffmann R, von Dahl J, Bosserhoff AK, Michaeli W, Hanrath P, Weber C, Blindt R (2004) Long-term assessment of a novel biodegradable paclitaxel-eluting coronary polylactide stent. Eur Heart J 25:1330–1340
Yamawaki T, Shimokawa H, Kozai T, Miyata K, Higo T, Tanaka E, Egashira K, Shiraishi T, Tamai H, Igaki K, Takeshita A (1998) Intramural delivery of a specific tyrosine kinase inhibitor with biodegradable stent suppresses the restenotic changes of the coronary artery in pigs in vivo. J Am Coll Cardiol 32:780–786
Robey TC, Eiselt PM, Murphy HS, Mooney DJ, Weatherly RA (2000) Biodegradable external tracheal stents and their use in a rabbit tracheal reconstruction model. Laryngoscope 110:1936–1942
Chepurov AK, Krivoborodov GG, Zubarev AV, Zaitsev NV, Markina N (2003) Biodegradable ureteral stents in treating patients with infravesical obstruction. Urologiia 44–50
Knutson T, Pettersson S, Dahlstrand C (2002) The use of biodegradable PGA stents to judge the risk of post-TURP incontinence in patients with combined bladder outlet obstruction and overactive bladder. Eur Urol 42:262–267
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Saito, Y., Tanaka, T., Andoh, A. et al. Novel Biodegradable Stents for Benign Esophageal Strictures Following Endoscopic Submucosal Dissection. Dig Dis Sci 53, 330–333 (2008). https://doi.org/10.1007/s10620-007-9873-6
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DOI: https://doi.org/10.1007/s10620-007-9873-6