Novel biodegradable stents for benign esophageal strictures following endoscopic submucosal dissection.
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.
Saito
Yasuharu
Y
Department of Endoscopic Medicine, Shiga University of Medical Science, Seta Tukinowa, Otsu 520-2192, Japan. ysaito@belle.shiga-med.ac.jp
Tanaka
Toyohiko
T
Andoh
Akira
A
Minematsu
Hideki
H
Hata
Kazunori
K
Tsujikawa
Tomoyuki
T
Nitta
Norihisa
N
Murata
Kiyoshi
K
Fujiyama
Yoshihide
Y
D020341:Absorbable Implants; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D004210:Dissection / Q000009:adverse effects; D004724:Endoscopy; D004938:Esophageal Neoplasms / Q000601:surgery; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D019344:Lactic Acid; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D011108:Polymers; D011474:Prosthesis Design; D015607:Stents
D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)
Clin Gastroenterol Hepatol. 2005 Jul;3(7 Suppl 1):S67-70
16013002
Radiology. 1997 Apr;203(1):131-6
9122381
Circulation. 2000 Jul 25;102(4):399-404
10908211
J Gastroenterol Hepatol. 2001 Apr;16(4):484-7
11354292
J Thorac Cardiovasc Surg. 1986 Mar;91(3):371-8
3951242
Urologiia. 2003 May-Jun;(3):44-50
12846099
Clin Mater. 1991;7(3):253-69
10149137
Radiology. 1994 Dec;193(3):689-95
7526414
Gastrointest Endosc. 2004 Dec;60(6):894-900
15605003
Eur Heart J. 2004 Aug;25(15):1330-40
15288161
Arch Surg. 1966 Nov;93(5):839-43
5921307
Laryngoscope. 2000 Nov;110(11):1936-42
11081614
Curr Interv Cardiol Rep. 2001 Feb;3(1):10-17
11177716
J Am Coll Cardiol. 1992 Aug;20(2):467-74
1634687
Gastrointest Endosc. 2004 Dec;60(6):1010-7
15605026
J Biomed Mater Res. 1990 May;24(5):529-45
2324125
J Bone Joint Surg Am. 1991 Jan;73(1):148-53
1985987
Eur Urol. 2002 Sep;42(3):262-7
12234511
J Am Coll Cardiol. 1998 Sep;32(3):780-6
9741527