Basic Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 7, 2019; 25(25): 3207-3217
Published online Jul 7, 2019. doi: 10.3748/wjg.v25.i25.3207
Silicone-covered biodegradable magnesium stent for treating benign esophageal stricture in a rabbit model
Kai Yang, Jun Cao, Tian-Wen Yuan, Yue-Qi Zhu, Bi Zhou, Ying-Sheng Cheng
Kai Yang, Bi Zhou, Ying-Sheng Cheng, Department of Radiological Intervention, Shanghai Sixth People's Hospital East Campus Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai 201306, China
Kai Yang, Bi Zhou, Ying-Sheng Cheng, Department of Radiological Intervention, Shanghai Sixth People's Hospital East Campus Affiliated to Shanghai Jiao Tong University, Shanghai 201306, China
Jun Cao, Tian-Wen Yuan, Department of Tumor Intervention, Dahua Hospital, Shanghai 200237, China
Yue-Qi Zhu, Department of Radiological Intervention, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
Author contributions: Yang K and Cao J contributed equally to this study; Yang K, Cheng YS, and Cao J designed all the experiments; Yang K, Yuan TW, and Zhu YQ performed the research; Zhou B contributed analytic tools; Yang K and Cao J wrote the paper.
Supported by the National Natural Science Foundation of China, No. 81371659, No. 81571773, and No. 81771943; and Shanghai Municipal Health and Family Planning Commission, No. 201640191.
Institutional animal care and use committee statement: All experimental protocols were approved by the Animal Research Council of Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University and followed the guidelines of the International Committee of Animal Care (US National Institutes of Health and European Commission).
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ying-Sheng Cheng, MD, PhD, Academic Fellow, Doctor, Department of Radiological Intervention, Shanghai Sixth People's Hospital East Campus Affiliated to Shanghai Jiao-tong University, No. 222, West Huanhu No. 3 Road, Shanghai 201306, China. chengyingsheng@hotmail.com
Telephone: +86-21-38297858 Fax: +86-21-38297706
Received: March 6, 2019
Peer-review started: March 7, 2019
First decision: April 8, 2019
Revised: May 14, 2019
Accepted: June 7, 2019
Article in press: June 8, 2019
Published online: July 7, 2019
Processing time: 121 Days and 22.5 Hours
Abstract
BACKGROUND

Stent insertion can effective alleviate the symptoms of benign esophageal strictures (BES). Magnesium alloy stents are a good candidate because of biological safety, but show a poor corrosion resistance and a quick loss of mechanical support in vivo.

AIM

To test the therapeutic and adverse effects of a silicone-covered magnesium alloy biodegradable esophageal stent.

METHODS

Fifteen rabbits underwent silicone-covered biodegradable magnesium stent insertion into the benign esophageal stricture under fluoroscopic guidance (stent group). The wall reconstruction and tissue reaction of stenotic esophagus in the stent group were compared with those of six esophageal stricture models (control group). Esophagography was performed at 1, 2, and 3 weeks. Four, six, and five rabbits in the stent group and two rabbits in the control groups were euthanized, respectively, at each time point for histological examination.

RESULTS

All stent insertions were well tolerated. The esophageal diameters at immediately, 1, 2 and 3 wk were 9.8 ± 0.3 mm, 9.7 ± 0.7 mm, 9.4 ± 0.8 mm, and 9.2 ± 0.5 mm, respectively (vs 4.9 ± 0.3 mm before stent insertion; P < 0.05). Magnesium stents migrated in eight rabbits [one at 1 wk (1/15), three at 2 wk (3/11), and four at 3 wk (4/5)]. Esophageal wall remodeling (thinner epithelial and smooth muscle layers) was found significantly thinner in the stent group than in the control group (P < 0.05). Esophageal injury and collagen deposition following stent insertion were similar and did not differ compared to rabbits with esophageal stricture and normal rabbits (P > 0.05).

CONCLUSION

Esophageal silicone-covered biodegradable magnesium stent insertion is feasible for BES without causing severe injury or tissue reaction. Our study suggests that insertion of silicone-covered magnesium esophageal stent is a promising approach for treating BES.

Keywords: Benign esophageal stricture; Biodegradable stent; Magnesium; Silicone membrane

Core tip: Stent insertion can be a safe, easy, and effective way to alleviate the symptoms of benign esophageal strictures (BES). However, metallic stent implantation is associated with some severe complications, such as migration, tissue ingrowth, and in-stent restenosis. Biodegradable stent has been used as an effective and accepted method to treat BES. We fabricated a silicone-covered biodegradable magnesium stent, and evaluated technical feasibility, tissue reaction, and stent degradation for treating benign esophageal stricture in a rabbit model. We found that implantation of silicone-covered magnesium stent provided reliable support for at least two weeks, suggesting that it is a promising strategy to treat benign esophageal stricture.