Covered Biodegradable Stent: New Therapeutic Option for the Management of Esophageal Perforation or Anastomotic Leak

Černá, Marie; Köcher, Martin; Válek, Vlastimil; Aujeský, R; Neoral, C; Andrašina, Tomáš; Pánek, Jiří; Mahathmakanthi, Shankari

doi:10.1007/s00270-010-0059-9

Cited by 60 publications

(21 citation statements)

References 18 publications

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“…Recently modified ELLA-BD stents with a non-BD covering made of polyurethane were used in five patients with esophageal leaks or perforations 41. The initial clinical success rate was 80%; however, the stent migration rate was 60%.…”

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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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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“…Potential pitfalls to biodegradable stents revealed by this study included the fact that stent migration occurred in three of the patients (although two migrated after leak sealing had been achieved) and one stent had to be removed owing to deformity. 8 The SX-ELLA stent used in this study consists of polydioxanone, which is a semicrystalline, biodegradable polymer. The stent is placed into a 28Fr applicator with an atraumatic dilator tip.…”

Section: Discussionmentioning

confidence: 99%

The novel use of a biodegradable stent placed by percutaneous transhepatic cholangiography for the treatment of a hepaticojejunostomy biliary leak following an extended left hepatectomy and pancreaticoduodenectomy

Jones

Moir

Brown

et al. 2014

annals

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A 61-year-old man presented with jaundice, and subsequently underwent an extended left hepatectomy and pancreaticoduodenectomy for a cholangiocarcinoma invading the head of the pancreas. The patient developed sepsis due to a biliary leak at the hepaticojejunostomy. We describe the original use of a biodegradable stent, deployed via percutaneous transhepatic cholangiography into the Roux limb, resulting in good drainage and resolution of sepsis. The chief benefit of this procedure is the lack of need for subsequent removal as well as purported reduced biofilm accumulation. We believe this to be the first reported case of this type and the literature surrounding the subject is also discussed.

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“…In one study of 5 patients with esophageal anastomotic leaks, a modified SX-ELLA-BD stent with a non-absorbable polyurethane covering was placed. 19 Early migration (within the first week after placement) occurred in 3 patients, while in one patient acute total dysphagia occurred due to collapse of the non-absorbable covering. 19 In addition, it appears that currently available BDS induce significant tissue hyperplasia and are frequently associated with severe pain and intolerance.…”

Section: Types Of Stentsmentioning

confidence: 99%

Enteral stents in the management of gastrointestinal leaks, perforations and fistulae

Shehab

Baron

2016

Int J Gastrointest Interv

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Gastrointestinal leaks and fistulae are grave conditions associated with substantial morbidity and mortality. Expandable stents have shown significant success in the management of leaks and fistulae, providing an efficacious minimally invasive approach in patients who are frequently poor surgical candidates. Most reports, however, are limited by their small size or the pooling of different stents, techniques and locations of leaks and fistulae. Despite the numerous alterations in stent design, migration remains the pivotal drawback of this technique. In this article, we review the current status of expandable stents in the management of gastrointestinal leaks and fistulae, available anti-migration techniques and evolving innovations in stent design.

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Covered Biodegradable Stent: New Therapeutic Option for the Management of Esophageal Perforation or Anastomotic Leak

Cited by 60 publications

References 18 publications

Plastic and Biodegradable Stents for Complex and Refractory Benign Esophageal Strictures

Plastic and Biodegradable Stents for Complex and Refractory Benign Esophageal Strictures

The novel use of a biodegradable stent placed by percutaneous transhepatic cholangiography for the treatment of a hepaticojejunostomy biliary leak following an extended left hepatectomy and pancreaticoduodenectomy

Enteral stents in the management of gastrointestinal leaks, perforations and fistulae

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