Abstract
Biodegradable stents have been used for more than a decade for the treatment of refractory benign esophageal stenosis. Once deployed, they reach their maximum diameter in a few days after deployment and maintain their initial radial force for a minimum of 5 weeks. This force is gradually reduced in the following weeks, and the stents are completely absorbed after 11–12 weeks of placement. Evidence from published studies demonstrates that their effectiveness is similar to other stent types (fully covered self-expandable metallic stents or plastic stents). Moreover, patients treated with biodegradable stents require fewer reinterventions during follow-up and no additional endoscopy to remove them. Biodegradable stent deployment is considered a safe procedure and is mainly related to minor, self-limited adverse events.
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Canena JM, Liberato MJ, Rio-Tinto RA et al (2012) A comparison of the temporary placement of 3 different self-expanding stents for the treatment of refractory benign esophageal strictures: a prospective multicentre study. BMC Gastroenterol 12:70
Celestin LR (1959) Permanent intubation in inoperable cancer of the oesophagus and cardia: a new tube. Ann R Coll Surg Engl 25:165–170
Dhar A, Close H, Viswanath YK et al (2014) Biodegradable stent or balloon dilatation for benign oesophageal stricture: pilot randomised controlled trial. World J Gastroenterol 20:18199–18206
Dua KS (2018) Expandable stents for benign esophageal disease. Gastrointest Endosc Clin N Am 21:359–376
Fry SW, Fleischer DE (1997) Management of a refractory benign esophageal stricture with a new biodegradable stent. Gastrointest Endosc 45:179–182
Fuccio L, Hassan C, Frazzoni L et al (2016) Clinical outcomes following stent placement in refractory benign esophageal stricture: a systematic review and meta-analysis. Endoscopy 48:141–148
Gangloff A, Lecleire S, Di Fiore A et al (2015) Fully versus partially covered self-expandable metal stents in benign esophageal strictures. Dis Esophagus 28:678–683
Goldin E, Fiorini A, Ratan Y et al (1996) A new biodegradable and self-expandable stent for benign esophageal strictures. Gastrointest Endosc 43:294
Harries R, Campbell J, Ghosh S (2010) Fractured migrated oesophageal stent fragment presenting as small bowel obstruction three years after insertion. Ann R Coll Surg Engl 92:W14–W15
Hindy P, Hong J, Lam-Tsai Y et al (2012) A comprehensive review of esophageal stents. Gastroenterol Hepatol (N Y) 8:526–523
Hirdes MM, Vleggaar FP, Siersema PD (2011) Stent placement for esophageal strictures: an update. Expert Rev Med Devices 8:733–755
Hirdes MM, Siersema PD, van Boeckel PG et al (2012) Single and sequential biodegradable stent placement for refractory benign esophageal strictures: a prospective follow-up study. Endoscopy 44:649–654
Hordijk ML, van Hooft JE, Hansen BE et al (2009) A randomized comparison of electrocautery incision with Savary bougienage for relief of anastomotic gastroesophageal strictures. Gastrointest Endosc 70:849–855
Jung GE, Sauer P, Schaible A (2010) Tracheoesophageal fistula following implantation of a biodegradable stent for a refractory benign esophageal stricture. Endoscopy 42(Suppl 2):E338–E339
Kochhar R, Samanta J, Basha J et al (2017) Biodegradable stents for caustic esophageal strictures: do they work? Dysphagia 32:575–582
Kochman ML, McClave SA, Boyce HW (2015) The refractory and the recurrent esophageal stricture: a definition. Gastrointest Endosc 62:474–475
Kumbum K (2019) Esopahgeal stricture. Available via MEDSCAPE. https://emedicine.medscape.com/article/175098. Accessed 28 Mar 2020
Ramage JI Jr, Rumalla A, Baron TH et al (2005) A prospective, randomized, double-blind, placebo-controlled trial of endoscopic steroid injection therapy for recalcitrant esophageal peptic strictures. Am J Gastroenterol 100:2419–2425
Reddy VM, Sutton CD, Miller AS (2009) Terminal ileum perforation as a consequence of a migrated and fractured oesophageal stent. Case Rep Gastroenterol 3:61–66
Reijm A, Didden P, Schelling S et al (2018) Twenty-three years of self-expandable metal stents placement for malignant esophageal strictures. Endoscopy 50:OP081
Rejchrt S, Kopacova M, Bartová J, Vacek Z et al (2009) Intestinal biodegradable stents: initial experience in the Czech Republic. Folia Gastroenterol Hepatol 7:7–11
Repici A, Vleggaar FP, Hassan C et al (2010) Efficacy and safety of biodegradable stents for refractory benign esophageal strictures: the BEST (Biodegradable Esophageal Stent) study. Gastrointest Endosc 72:927–934
Repici A, Small AJ, Mendelson A et al (2016) Natural history and management of refractory benign esophageal strictures. Gastrointest Endosc 84:222–228
Saito Y, Tanaka T, Andoh A et al (2007) Usefulness of biodegradable stents constructed of poly-l-lactic acid monofilaments in patients with benign esophageal stenosis. World J Gastroenterol 13:3977–3980
Sandha GS, Marcon NE (1999) Expandable metal stents for benign esophageal obstruction. Gastrointest Endosc Clin N Am 9:437–446
Siersema PD (2008) Treatment options for esophageal strictures. Nat Clin Pract Gastroenterol Hepatol 5:142–152
Siersema PD (2019) How to approach a patient with refractory or recurrent benign esophageal stricture. Gastroenterology 156:7–10
Sigounas DE, Siddhi S, Plevris JN (2016) Biodegradable esophageal stents in benign and malignant strictures – a single center experience. Endosc Int Open 4:E618–E623
Spaander MC, Baron TH, Siersema PD et al (2016) Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 48:939–948
Tanaka T, Takahashi M, Nitta N et al (2006) Newly developed biodegradable stents for benign gastrointestinal tract stenoses: a preliminary clinical trial. Digestion 74:199–205
Uitdehaag MJ, van Hooft JE, Verschuur EM et al (2009) A fully-covered stent (Alimaxx-E) for the palliation of malignant dysphagia: a prospective follow-up study. Gastrointest Endosc 70:1082–1089
van Boeckel PG, Vleggaar FP, Siersema PD (2011) A comparison of temporary self-expanding plastic and biodegradable stents for refractory benign esophageal strictures. Clin Gastroenterol Hepatol 9:653–659
van Halsema EE, van Hooft JE (2015) Clinical outcomes of self-expandable stent placement for benign esophageal diseases: a pooled analysis of the literature. World J Gastrointest Endosc 7:135–153
van Hooft JE, van Berge Henegouwen MI, Rauws EA et al (2011) Endoscopic treatment of benign anastomotic esophagogastric strictures with a biodegradable stent. Gastrointest Endosc 73:1043–1047
Vermeulen BD, Siersema PD (2018) Esophageal stenting in clinical practice: an overview. Curr Treat Options Gastroenterol 16:260–273
Verschuur EM, Repici A, Kuipers EJ et al (2008) New design esophageal stents for the palliation of dysphagia from esophageal or gastric cardia cancer: a randomized trial. Am J Gastroenterol 103:304–312
Vleggaar FP, Siersema PD (2011) Expandable stents for malignant esophageal disease. Gastrointest Endosc Clin N Am 21:377–388
Walter D, van den Berg MW, Hirdes MM et al (2018) Dilation or biodegradable stent placement for recurrent benign esophageal strictures: a randomized controlled trial. Endoscopy 50:1146–1155
Yano T, Yoda Y, Nomura S et al (2017) Prospective trial of biodegradable stents for refractory benign esophageal strictures after curative treatment of esophageal cancer. Gastrointest Endosc 86:492–499
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Gkolfakis, P., Papanikolaou, I.S., Siersema, P. (2021). Biodegradable Self-Expandable Stents for Benign Strictures: Indications and Outcomes. In: Testoni, P.A., Inoue, H., Wallace, M.B. (eds) Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-29964-4_53-1
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DOI: https://doi.org/10.1007/978-3-030-29964-4_53-1
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