Novel Biodegradable Stents for Benign Esophageal Strictures Following Endoscopic Submucosal Dissection

Abstract

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.

Effect of Oral Prednisolone on Esophageal Stricture after Complete Circular Endoscopic Submucosal Dissection for Superficial Esophageal Squamous Cell Carcinoma: A Case Report

“…There are other ways to treat esophageal stenosis, such as temporary stent insertion and local corticosteroid injection [10,19]. Prior studies suggest the usefulness of intralesional steroid injection into benign esophageal strictures for augmentation of the effects of endoscopic dilatation [10,11].…”

“…It is postulated that triamcinolone can prevent the cross-linking of collagen that results in scar stricture [20]. More recently, there have been several preclinical or preliminary studies to overcome esophageal strictures using new technologies, such as biodegradable stents [19] or autologous oral mucosal sheets [21]. However, until these are available in the clinical setting, our experience with systemic prednisolone administration for complete circular ESD may offer an alternative to decrease the risk of benign esophageal strictures and reduce the number of EBD sessions.…”

Management of strictures after endoscopic submucosal dissection for superficial esophageal cancer

“…Recently, oral mucosal epithelial cell sheet transplantation applying regenerative medicine technology (18,19), and the usefulness of biodegradable stents (20) have been reported and new clinical applications are expected. In cell sheet transplantation, expensive medical expenses are required to prepare cell sheets, and there are problems to be solved such as it taking no less than 2 weeks at Tokyo Women's Medical University Hospital.…”

Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

“…Saito et al [52] reported two cases in whom biodegradable stents for post-ESD esophageal strictures were successfully placed. In both lesions, the mucosal defect had extended to seven-eighths of the circumference.…”