Biodegradable stents for caustic esophageal strictures: a new therapeutic approach

Karakan, Tarkan; Utku, Özlem Gül; Dorukoz, O.; Şen, İ̇lker; Çolak, Bülent; Erdal, Harun; Karatay, Eylem; Tahtaci, Mustafa; Cengiz, Mustafa

doi:10.1111/j.1442-2050.2012.01418.x

Cited by 38 publications

(19 citation statements)

References 10 publications

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“…Retrosternal chest pain reflects the process of stent deployment in order to achieve its planned diameter. The pain is usually self-limited; however, analgesics, including opioids, may be required to control it [41]. Rarely, the pain may persist for a long period of time or may be not tolerated by the patient, leading to early stent removal to relieve the patient's symptoms.…”

Section: Safety Outcomes -Complicationsmentioning

confidence: 99%

Biodegradable esophageal stents for the treatment of refractory benign esophageal strictures

Gkolfakis

Siersema

Tziatzios

et al. 2020

aog

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This review attempts to present the available evidence regarding the use of biodegradable stents in refractory benign esophageal strictures, especially highlighting their impact on clinical success and complications. A comprehensive literature search was conducted in PubMed, using the terms "biodegradable" and "benign"; evidence from cohort and comparative studies, as well as data from one pooled analysis and one meta-analysis are presented. In summary, the results from these studies indicate that the effectiveness of biodegradable stents ranges from more than one third to a quarter of cases, fairly similar to other types of stents used for the same indication. However, their implementation may reduce the need for re-intervention during follow up. Biodegradable stents also seem to reduce the need for additional types of endoscopic therapeutic modalities, mostly balloon or bougie dilations. Results from pooled data are consistent, showing moderate efficacy along with a higher complication rate. Nonetheless, the validity of these results is questionable, given the heterogeneity of the studies included. Finally, adverse events may occur at a higher rate but are most often minor. The lack of high-quality studies with sufficient patient numbers mandates further studies, preferably randomized, to elucidate the exact role of biodegradable stents in the treatment of refractory benign esophageal strictures. AbstractI N V I T E D R E V I E W 2 P. Gkolfakis et al Annals of Gastroenterology 32

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Section: Safety Outcomes -Complicationsmentioning

confidence: 99%

Biodegradable esophageal stents for the treatment of refractory benign esophageal strictures

Gkolfakis

Siersema

Tziatzios

et al. 2020

aog

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“…Our systematic review of 111 patients with a benign esophageal stricture obtained from nine studies showed the following results: technical success rate of 96%, clinical success rate of 47%, early stent migration rate of 21%, and tissue hyperplasia rate of 13% (Table 3). 12,21,30,32,33,34,35,39,40…”

Section: Biodegradable Stentmentioning

confidence: 99%

Plastic and Biodegradable Stents for Complex and Refractory Benign Esophageal Strictures

Ham

Kim

2014

Clin Endosc

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Endoscopic stent placement is a well-accepted and effective alternative treatment modality for complex and refractory esophageal strictures. Among the currently available types of stents, the partially covered self-expanding metal stent (SEMS) has a firm anchoring effect, preventing stent migration and ensuring effective covering of a narrowed segment. However, hyperplastic tissue reaction driven by the uncovered mesh may prevent easy and safe stent removal. As an alternative, a fully covered SEMS decreases the recurrence of dysphagia caused by hyperplastic tissue ingrowth; however, it has a high migration rate. Likewise, although a self-expanding plastic stent (SEPS) reduces reactive hyperplasia, the long-term outcome is disappointing because of the high rate of stent migration. A biodegradable stent has the main benefit of not requiring stent removal in comparison with SEMS and SEPS. However, it still has a somewhat high rate of hyperplastic reaction, and the long-term outcome does not satisfy expectations. Up to now, the question of which type of stent should be recommended for the effective treatment of complex and refractory benign strictures has no clear answer. Therefore, the selection of stent type for endoscopic treatment should be individualized, taking into consideration the endoscopist's experience as well as patient and stricture characteristics.

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“…In contrast to the advances in materials and technology, there is absence of specially designed esophageal SEMSs for children regarding their age and size. Therefore, stents that are made from different materials [9,10,16,24] and originally designed for other organs are used as an "off-label technique" in the pediatric population [7,9,18,23]. In this study, the number of stents ranged between one and three different biliary and/or bronchial SEMSs that were successively placed.…”

Section: Discussionmentioning

confidence: 99%

Experience with Fully Covered Self-Expandable Metal Stents for Esophageal Leakage in Children

et al. 2019

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Background There is a lack of experience with fully covered self-expandable metal stents (SEMSs) for the treatment of esophageal leakage particularly in infants and neonates. Methods Eight patients (5M, 3F) with a median age of 17 months (range, 1–135 months) who underwent treatment with SEMSs for an anastomotic leakage or perforation of the esophagus were recruited to this retrospective study. Four children were born premature. In six patients the stents were placed primarily as an emergency procedure. Results Median duration of individual stent placement was 42 days (range, 13–72 days). Six out of eight patients (75%) were treated with one stent only. In three preterm infants who had their stents inserted within the first month relative weight gain was 17% compared with 2% in five patients who were treated later in life (p=0.0986). In four cases (50%) distal migration of the stent was observed. Seven out of eight patients (88%) had their leakage resolved after stent therapy. Conclusions Insertion of fully covered SEMSs is an alternative tool for the treatment of esophageal leakage in children and preterm infants, and successful with only one single application in selected cases. It can be used either following previous therapy or as part of an emergency procedure. Because of the absence of manufactured, age-related devices SEMSs that are originally designed for other organs can be applied.

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Biodegradable stents for caustic esophageal strictures: a new therapeutic approach

Cited by 38 publications

References 10 publications

Biodegradable esophageal stents for the treatment of refractory benign esophageal strictures

Biodegradable esophageal stents for the treatment of refractory benign esophageal strictures

Plastic and Biodegradable Stents for Complex and Refractory Benign Esophageal Strictures

Experience with Fully Covered Self-Expandable Metal Stents for Esophageal Leakage in Children

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