Efficacy of triamcinolone-soaked polyglycolic acid sheet plus fully covered metal stent for preventing stricture formation after large esophageal endoscopic submucosal dissection

Li, L; Linghu, Enqiang; Chai, Ningli; Li, Z; Zou, Jianfeng; Du, Chen; Wang, X; Xiang, Jia

doi:10.1093/dote/doy121

Cited by 16 publications

(15 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, a few recent studies have evaluated the efficacy of polyglycolic acid sheet combined with covered SEMS for prevention of stricture formation after large esophageal endoscopic submucosal dissection (ESD) [63][64][65]. The rate of post-ESD esophageal stricture appears to be lower in patients treated with polyglycolic sheet SEMS when compared to patients treated with conventional SEMS or intralesional steroid injection, with similar safety profile, making it a promising alternative in this context.…”

Section: Irradiating and Drug Eluting Gastrointestinal Stentsmentioning

confidence: 99%

Futuristic Developments and Applications in Endoluminal Stenting

Ferreira‐Silva

Medas

Girotra

et al. 2022

Gastroenterology Research and Practice

View full text Add to dashboard Cite

Endoscopic stenting is a well-established option for the treatment of malignant obstruction, temporary management of benign strictures, and sealing transmural defects, as well as drainage of pancreatic fluid collections and biliary obstruction. In recent years, in addition to expansion in indications for endoscopic stenting, considerable strides have been made in stent technology, and several types of devices with advanced designs and materials are continuously being developed. In this review, we discuss the important developments in stent designs and novel indications for endoluminal and transluminal stenting. Our discussion specifically focuses on (i) biodegradable as well as (ii) irradiating and drug-eluting stents for esophageal, gastroduodenal, biliary, and colonic indications, (iii) endoscopic stenting in inflammatory bowel disease, and (iv) lumen-apposing metal stent.

show abstract

Section: Irradiating and Drug Eluting Gastrointestinal Stentsmentioning

confidence: 99%

Futuristic Developments and Applications in Endoluminal Stenting

Ferreira‐Silva

Medas

Girotra

et al. 2022

Gastroenterology Research and Practice

View full text Add to dashboard Cite

show abstract

“…One small case series showed rather promising results with a stent covered by triamcinolone-soaked polyglycolic acid sheet in patients after extensive esophageal ESD. No stricture occurred in patients with noncircumferential resection and stricture occurred in 50 % (3/6) patients with circumferential resection 23 .…”

Section: Discussionmentioning

confidence: 92%

Stenting to prevent esophageal stricture after circumferential endoscopic submucosal dissection: an experimental study

et al. 2020

View full text Add to dashboard Cite

Background and study aims Circular ESD (CESD) is a treatment option for patients with extensive early esophageal cancer. Its major drawback is the development of a stricture. Stenting may represent an attractive prevention strategy. We designed an experimental study to assess the effect of stents covered with acellular biomatrix (AB) and a drug-eluting stent. Materials and methods Thirty-five 35 pigs underwent CESD and were randomized into six groups: G1 (control), G2 (SEMS), G3 (SEMS + AB), G4 (SEMS + AB + steroid-eluting layer), G5 (biodegradable stent [BD]), G6 (BD + AB). SEMS were placed alongside the post-CESD defect, fixed and removed after 21 days. The main outcomes were stricture development, severity, and histopathology. Results Pigs with BD stents (G5, 6) experienced severe inflammation and hypergranulation without biodegradation, therefore, these groups were closed prematurely. Significant strictures developed in 29 of 30 pigs (96.7 %). The most severe stricture developed in G2 and G4 (narrowest diameter (mm) 8.5 ± 3, 3 (G2) and 8.6 ± 2.1 (G4) vs. 17 ± 7.3 (G1) and 13.5 ± 8.3 (G3); P < 0.01. Signs of re-epithelization were present in 67 % and 71 % in G1 and G2 and in 100 % in G3 and G4. The most robust re-epithelization layer was present in G4. The inflammation was the most severe in G1 (mean score 2.3) and least severe in G4 (0.4). Conclusions Stenting did not effectively prevent development of post-CESD esophageal stricture. SEMS with AB resulted in improved re-epithelization and decreased stricture severity. Steroid-eluting SEMS suppressed inflammation. BD stents seem inappropriate for this indication.

show abstract

“…Several studies have evaluated the effectiveness of PGA sheets, esophageal covered metal stents or the combined application of both. The esophageal stricture rates were reported to be 18-57.5% (33)(34)(35)(36). However, these approaches have major limitations, including early stent migration, cost, complexity of the procedures and requirement of a high degree of expertise.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of fibrin sealant as a hemostatic technique in accelerating endoscopic submucosal dissection-induced ulcer healing and preventing stricture in the esophagus: A retrospective study

Wang

et al. 2020

Oncol Lett

View full text Add to dashboard Cite

The aim of the present retrospective study was to evaluate the effectiveness of conservative electrocoagulation followed by porcine fibrin sealant (FS) as a protective hemostatic technique for wounded microvessels in promoting the healing of endoscopic submucosal dissection (ESD)-induced ulcer, and preventing esophageal strictures that follow ESD. A total of 203 patients with early esophageal cancer or precancerous lesions were retrospectively analyzed. The 1-month ulcer healing and stricture rates were compared between the two groups (combined hemostats and electrocautery groups). The 1-month complete healing rate was 77.0% in the combined hemostats group and 52.6% in the electrocautery group (P=0.003). The use of FS and a smaller resected range (<3/4 circumference) was associated with a better 1-month healing rate. For patients with a ≥3/4 circumference mucosal defect, the esophageal stricture rate was 31.6% (6/19) in the combined hemostats group and 25.0% (2/8) in the electrocautery group. There was no difference in the stricture rate (P=0.737) and dilation time (P=0.733) between the two groups. In conclusion, the application of conservative electrocoagulation followed by porcine FS as a wound-protection technique promoted ESD-induced ulcer healing in the esophagus. However, this combined hemostatic technique was not superior to the conventional hemostatic method in preventing post-ESD stricture in patients with large esophageal mucosal defects.

show abstract

Efficacy of triamcinolone-soaked polyglycolic acid sheet plus fully covered metal stent for preventing stricture formation after large esophageal endoscopic submucosal dissection

Cited by 16 publications

References 23 publications

Futuristic Developments and Applications in Endoluminal Stenting

Futuristic Developments and Applications in Endoluminal Stenting

Stenting to prevent esophageal stricture after circumferential endoscopic submucosal dissection: an experimental study

Effectiveness of fibrin sealant as a hemostatic technique in accelerating endoscopic submucosal dissection-induced ulcer healing and preventing stricture in the esophagus: A retrospective study

Contact Info

Product

Resources

About