Recent Advances of Biomedical Materials for Prevention of Post-ESD Esophageal Stricture

Abstract

Esophageal stricture commonly occurs in patients that have suffered from endoscopic submucosal dissection (ESD), and it makes swallowing difficult for patients, significantly reducing their life qualities. So far, the prevention strategies applied in clinical practice for post-ESD esophageal stricture usually bring various inevitable complications, which drastically counteract their effectiveness. Nowadays, with the widespread investigation and application of biomedical materials, lots of novel approaches have been devised in terms of the prevention of esophageal stricture. Biomedical polymers and biomedical-derived materials are the most used biomedical materials to prevent esophageal stricture after ESD. Both of biomedical polymers and biomedical-derived materials possess great physicochemical properties such as biocompatibility and biodegradability. Moreover, some biomedical polymers can be used as scaffolds to promote cell growth, and biomedical-derived materials have biological functions similar to natural organisms, so they are important in tissue engineering. In this review, we have summarized the current approaches for preventing esophageal stricture and put emphasis on the discussion of the roles biomedical polymers and biomedical-derived materials acted in esophageal stricture prevention. Meanwhile, we proposed several potential methods that may be highly rational and feasible in esophageal stricture prevention based on other researches associated with biomedical materials. This review is expected to offer a significant inspiration from biomedical materials to explore more effective, safer, and more economical strategies to manage post-ESD esophageal stricture.

Antibacterial-Based Hydrogel Coatings and Their Application in the Biomedical Field—A Review

“…In the current biomedical field, medical devices, such as catheters, hernia nets, implants, and wound dressings, are often adhered by bacteria, leading to varying degrees of infection and posing a threat to the health of patients [1]. Once bacteria adhere to the surface of the substrate, they will rapidly form a biofilm, which attracts more bacteria, affecting the antibacterial effect of the immune system [2].…”

Short Peptide Nanofiber Biomaterials Ameliorate Local Hemostatic Capacity of Surgical Materials and Intraoperative Hemostatic Applications in Clinics

“…Some biomaterial-based new techniques have been reviewed to improve the bleeding management and prevent post-ESD esophageal stricture. [197,199] To explore peptide hydrogel tissue engineering strategy for endoscopic treatment of Barrett's esophagus, an array of synthetic SAP hydrogels (PGD-CGD 2 and PGD-AlphaProC) with desired combinations of mechanical and charge properties was designed to co-cultivate esophageal epithelial and stromal cells and form epithelial cell sheet structure for the therapy of esophageal stricture. [200] This synthetic peptide nanomaterial served as biological scaffolding matrix to enhance mucosal epithelial cell adhesion, proliferation, differentiation, stratification, and esophageal mucosal regeneration, which are greatly useful to develop effective MIS treatments to prevent esophageal stricture in Barrett's esophagus.…”

“…However, extensive endoscopic resection of esophageal lesion can cause post‐operative esophageal strictures in almost 90% of the patients ( Figure A). [ 197 ] So, esophageal reconstruction is one core surgical issue and post‐operative bleeding is a severe adverse event, except that intraoperative bleeding often makes esophageal ESD more difficult and time‐consuming. Effective hemostatic agents are of paramount significance in intraoperative hemorrhage management and lots of innovative approaches are simultaneously devised to prevent esophageal strictures, [ 198 ] such as mechanical, anti‐proliferative, regenerative, and protective methods.…”

“…[ 210 ] It is stressed that RADA16 peptide hydrogel keeps a visible endoscopic view with all‐volume transparency in surgical scope that facilitates the operative procedure performed easily, which is the veritable merit of this hemostatic device. Compared with other hemostatic materials, [ 197 ] the synthetic dSAP hydrogel‐based hemostatic materials exhibit some outstanding prospects and multifaceted compliant capacity to achieve robust hemostasis and residual mucosa repairs in the treatment of esophageal stricture.…”

Predictive Value of the Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio Esophageal Stricture After Endoscopic Submucosal Dissection of Early Esophageal Cancer

“…It has the advantages of a high resection rate, small wound, less bleeding, good curative effect, and rapid postoperative recovery, but it is difficult to operate and can easily lead to esophageal stricture. Post-ESD esophageal strictures in EEC can cause dysphagia of varying severity and reduce the quality of life of patients [ 3 , 4 ]. However, most patients are discovered to have esophageal stricture after presenting with dysphagia.…”