title: Biodegradable polydioxanone stents: a new option for therapy-resistant anastomotic strictures of the colon.
abstract: OBJECTIVE
  To assess the outcome of self-expandable, biodegradable stent insertion for anastomotic strictures following treatment for rectosigmoid carcinoma.
  
  
  METHODS
  Three male patients (median age 66) developed benign strictures after radiotherapy and resection of a recto-sigmoid carcinoma. These were resistant to balloon dilatation and prevented stoma reversal. Biodegradable stent insertion was performed as an experimental treatment on a named-patient basis with approval of the institutional review board. Patients had monthly follow-up with endoscopy and contrast medium enemas to monitor performance and degradation of the stents.
  
  
  RESULTS
  All stents were placed successfully without complications after pre-dilatation to 20 mm under fluoroscopic guidance. Stent degradation occurred in all patients 4-5 months following implantation, and long-term anastomotic patency was demonstrated in all. This allowed reversal of the colostomy and physiological defecation in two patients. Reversal was not undertaken in one due to subsequent development of liver metastases. No stent migration or occlusion occurred.
  
  
  CONCLUSIONS
  Biodegradable stents can maintain an adequate lumen across anastomotic strictures resistant to balloon dilatation. They seem to allow stricture re-modelling resulting in maintained dilatation after degradation. This potentially allows reversal of a colostomy, which might otherwise be prevented by stricture recurrence.
authors.affiliation: Department of Radiodiagnostics, 3rd Medical Faculty, Charles University, Prague, Czech Republic.
authors.forename: Václav
authors.initials: V
authors.lastname: Janík
authors.forename: Ladislav
authors.initials: L
authors.lastname: Horák
authors.forename: Jan
authors.initials: J
authors.lastname: Hnaníček
authors.forename: Jiří
authors.initials: J
authors.lastname: Málek
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Laasch
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects* / Q000379:methods; D002404:Catheterization / Q000009:adverse effects / Q000379:methods; D003082:Colectomy / Q000009:adverse effects / Q000379:methods; D003125:Colostomy / Q000009:adverse effects; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016687:Polydioxanone; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D019233:Retreatment; D018570:Risk Assessment; D012494:Sampling Studies; D015607:Stents; D016896:Treatment Outcome
chemical_list: D016687:Polydioxanone