A Novel Biodegradable Tubular Stent Prevents Pancreaticojejunal Anastomotic Stricture
Stricture of pancreatic-enteric anastomoses is a major late complication of a pancreaticoduodenectomy for the treatment of a periampullary tumor and can lead to exocrine and endocrine insufficiency such as malnutrition and diabetes mellitus. We investigated the safety and efficacy of a biodegradable...
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| Veröffentlicht in: | Scientific reports 2020-01, Vol.10 (1), p.1518-1518, Article 1518 |
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| creator | Bakheet, Nader Park, Jung-Hoon Shin, Sang Hyun Hong, Sarang Park, Yejong Shim, In Kyong Hwang, Changmo Jeon, Jae Yong Lopera, Jorge E. Song, Ho-Young Kim, Song Cheol |
| description | Stricture of pancreatic-enteric anastomoses is a major late complication of a pancreaticoduodenectomy for the treatment of a periampullary tumor and can lead to exocrine and endocrine insufficiency such as malnutrition and diabetes mellitus. We investigated the safety and efficacy of a biodegradable tubular stent (BTS) for preventing a pancreaticojejunostomy (PJ) anastomotic stricture in both a rat and porcine model. The BTS was manufactured using a terpolymer comprising poly p-dioxanone, trimethylene carbonate, and glycolide. A cohort of 42 rats was randomized into 7 groups of 6 animals each after BTS placement into the duodenum for the biodegradation assay. A total of 12 pigs were randomized equally into a control and BTS placement group. The effectiveness of the BTS was assessed by comparing radiologic images with histologic results. Surgical procedures and/or BTS placements were technically successful in all animals. The median mass losses of the removed BTS samples from the rat duodenum were 2.1, 6.8, 11.2, 19.4, 26.1, and 56.8% at 1, 2, 3, 4, 6, and 8 weeks, respectively. The BTS had completely degraded at 12 weeks in the rats. In the porcine PJ model, the mean luminal diameter and area of the pancreatic duct in the control group was significantly larger than in the BTS group (all
p
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| doi_str_mv | 10.1038/s41598-019-57271-4 |
| format | Article |
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p
< 0.05). BTS placement thus appears to be safe and effective procedure for the prevention of PJ anastomotic stricture. These devices have the potential to be used as a temporary stent placement to treat pancreatic-enteric anastomoses, but further investigations are required for optimization in human.</description><identifier>ISSN: 2045-2322</identifier><identifier>EISSN: 2045-2322</identifier><identifier>DOI: 10.1038/s41598-019-57271-4</identifier><identifier>PMID: 32001759</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>631/67/1504/1713 ; 639/166/985 ; 692/308/2778 ; 692/308/575 ; 692/4020/1503/1712/1713 ; Absorbable Implants - veterinary ; Anastomosis, Surgical - instrumentation ; Anastomosis, Surgical - methods ; Animals ; Biodegradability ; Biodegradation ; Constriction, Pathologic - surgery ; Diabetes mellitus ; Disease Models, Animal ; Duodenum ; Humanities and Social Sciences ; Implants ; Male ; Malnutrition ; multidisciplinary ; Pancreas ; Pancreas - surgery ; Pancreatic Ducts - surgery ; Pancreaticoduodenectomy ; Pancreaticoduodenectomy - adverse effects ; Pancreaticoduodenectomy - methods ; Pancreaticojejunostomy ; Postoperative Complications - surgery ; Rats ; Rats, Sprague-Dawley ; Science ; Science (multidisciplinary) ; Stents ; Stricture ; Swine</subject><ispartof>Scientific reports, 2020-01, Vol.10 (1), p.1518-1518, Article 1518</ispartof><rights>The Author(s) 2020</rights><rights>This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-4a48af72d706efd41ef29cc25c942e8724580b298407ba00b9e0f2cae8be471e3</citedby><cites>FETCH-LOGICAL-c474t-4a48af72d706efd41ef29cc25c942e8724580b298407ba00b9e0f2cae8be471e3</cites><orcidid>0000-0002-1408-9048 ; 0000-0001-9114-7750 ; 0000-0002-0614-8271 ; 0000-0003-4552-4169 ; 0000-0002-2533-4491</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6992790/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6992790/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,41120,42189,51576,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32001759$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bakheet, Nader</creatorcontrib><creatorcontrib>Park, Jung-Hoon</creatorcontrib><creatorcontrib>Shin, Sang Hyun</creatorcontrib><creatorcontrib>Hong, Sarang</creatorcontrib><creatorcontrib>Park, Yejong</creatorcontrib><creatorcontrib>Shim, In Kyong</creatorcontrib><creatorcontrib>Hwang, Changmo</creatorcontrib><creatorcontrib>Jeon, Jae Yong</creatorcontrib><creatorcontrib>Lopera, Jorge E.</creatorcontrib><creatorcontrib>Song, Ho-Young</creatorcontrib><creatorcontrib>Kim, Song Cheol</creatorcontrib><title>A Novel Biodegradable Tubular Stent Prevents Pancreaticojejunal Anastomotic Stricture</title><title>Scientific reports</title><addtitle>Sci Rep</addtitle><addtitle>Sci Rep</addtitle><description>Stricture of pancreatic-enteric anastomoses is a major late complication of a pancreaticoduodenectomy for the treatment of a periampullary tumor and can lead to exocrine and endocrine insufficiency such as malnutrition and diabetes mellitus. We investigated the safety and efficacy of a biodegradable tubular stent (BTS) for preventing a pancreaticojejunostomy (PJ) anastomotic stricture in both a rat and porcine model. The BTS was manufactured using a terpolymer comprising poly p-dioxanone, trimethylene carbonate, and glycolide. A cohort of 42 rats was randomized into 7 groups of 6 animals each after BTS placement into the duodenum for the biodegradation assay. A total of 12 pigs were randomized equally into a control and BTS placement group. The effectiveness of the BTS was assessed by comparing radiologic images with histologic results. Surgical procedures and/or BTS placements were technically successful in all animals. The median mass losses of the removed BTS samples from the rat duodenum were 2.1, 6.8, 11.2, 19.4, 26.1, and 56.8% at 1, 2, 3, 4, 6, and 8 weeks, respectively. The BTS had completely degraded at 12 weeks in the rats. In the porcine PJ model, the mean luminal diameter and area of the pancreatic duct in the control group was significantly larger than in the BTS group (all
p
< 0.05). BTS placement thus appears to be safe and effective procedure for the prevention of PJ anastomotic stricture. These devices have the potential to be used as a temporary stent placement to treat pancreatic-enteric anastomoses, but further investigations are required for optimization in human.</description><subject>631/67/1504/1713</subject><subject>639/166/985</subject><subject>692/308/2778</subject><subject>692/308/575</subject><subject>692/4020/1503/1712/1713</subject><subject>Absorbable Implants - veterinary</subject><subject>Anastomosis, Surgical - instrumentation</subject><subject>Anastomosis, Surgical - methods</subject><subject>Animals</subject><subject>Biodegradability</subject><subject>Biodegradation</subject><subject>Constriction, Pathologic - surgery</subject><subject>Diabetes mellitus</subject><subject>Disease Models, Animal</subject><subject>Duodenum</subject><subject>Humanities and Social Sciences</subject><subject>Implants</subject><subject>Male</subject><subject>Malnutrition</subject><subject>multidisciplinary</subject><subject>Pancreas</subject><subject>Pancreas - surgery</subject><subject>Pancreatic Ducts - surgery</subject><subject>Pancreaticoduodenectomy</subject><subject>Pancreaticoduodenectomy - adverse effects</subject><subject>Pancreaticoduodenectomy - methods</subject><subject>Pancreaticojejunostomy</subject><subject>Postoperative Complications - surgery</subject><subject>Rats</subject><subject>Rats, Sprague-Dawley</subject><subject>Science</subject><subject>Science (multidisciplinary)</subject><subject>Stents</subject><subject>Stricture</subject><subject>Swine</subject><issn>2045-2322</issn><issn>2045-2322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kU1LxDAQhoMoKuof8CAFL16qk2lqmouwil8gKqjnkKbTtUu30aRd8N-bddfPg7lMyDzzzmRexnY5HHLIiqMgeK6KFLhKc4mSp2KFbSKIPMUMcfXHfYPthDCBeHJUgqt1tpEhAJe52mRPo-TWzahNThtX0dibypQtJY9DObTGJw89dX1y72kWY0juTWc9mb6xbkKToTNtMupM6N3UxbdI-8b2g6dttlabNtDOMm6xp4vzx7Or9Obu8vpsdJNaIUWfCiMKU0usJBxTXQlONSprMbdKIBUSRV5AiaoQIEsDUCqCGq2hoiQhOWVb7GSh-zKUU6psHNKbVr_4Zmr8m3am0b8zXfOsx26mj5VCqSAKHCwFvHsdKPR62gRLbWs6ckPQmOUASsT-Ed3_g07c4OMK5pQopJRx4ZHCBWW9C8FT_TUMBz03Ti-M09E4_WGcFrFo7-c3vko-bYpAtgBCTHVj8t-9_5F9Bx0LpLI</recordid><startdate>20200130</startdate><enddate>20200130</enddate><creator>Bakheet, Nader</creator><creator>Park, Jung-Hoon</creator><creator>Shin, Sang Hyun</creator><creator>Hong, Sarang</creator><creator>Park, Yejong</creator><creator>Shim, In Kyong</creator><creator>Hwang, Changmo</creator><creator>Jeon, Jae Yong</creator><creator>Lopera, Jorge E.</creator><creator>Song, Ho-Young</creator><creator>Kim, Song Cheol</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>88I</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1408-9048</orcidid><orcidid>https://orcid.org/0000-0001-9114-7750</orcidid><orcidid>https://orcid.org/0000-0002-0614-8271</orcidid><orcidid>https://orcid.org/0000-0003-4552-4169</orcidid><orcidid>https://orcid.org/0000-0002-2533-4491</orcidid></search><sort><creationdate>20200130</creationdate><title>A Novel Biodegradable Tubular Stent Prevents Pancreaticojejunal Anastomotic Stricture</title><author>Bakheet, Nader ; Park, Jung-Hoon ; Shin, Sang Hyun ; Hong, Sarang ; Park, Yejong ; Shim, In Kyong ; Hwang, Changmo ; Jeon, Jae Yong ; Lopera, Jorge E. ; Song, Ho-Young ; Kim, Song Cheol</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-4a48af72d706efd41ef29cc25c942e8724580b298407ba00b9e0f2cae8be471e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>631/67/1504/1713</topic><topic>639/166/985</topic><topic>692/308/2778</topic><topic>692/308/575</topic><topic>692/4020/1503/1712/1713</topic><topic>Absorbable Implants - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Scientific reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bakheet, Nader</au><au>Park, Jung-Hoon</au><au>Shin, Sang Hyun</au><au>Hong, Sarang</au><au>Park, Yejong</au><au>Shim, In Kyong</au><au>Hwang, Changmo</au><au>Jeon, Jae Yong</au><au>Lopera, Jorge E.</au><au>Song, Ho-Young</au><au>Kim, Song Cheol</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Novel Biodegradable Tubular Stent Prevents Pancreaticojejunal Anastomotic Stricture</atitle><jtitle>Scientific reports</jtitle><stitle>Sci Rep</stitle><addtitle>Sci Rep</addtitle><date>2020-01-30</date><risdate>2020</risdate><volume>10</volume><issue>1</issue><spage>1518</spage><epage>1518</epage><pages>1518-1518</pages><artnum>1518</artnum><issn>2045-2322</issn><eissn>2045-2322</eissn><abstract>Stricture of pancreatic-enteric anastomoses is a major late complication of a pancreaticoduodenectomy for the treatment of a periampullary tumor and can lead to exocrine and endocrine insufficiency such as malnutrition and diabetes mellitus. We investigated the safety and efficacy of a biodegradable tubular stent (BTS) for preventing a pancreaticojejunostomy (PJ) anastomotic stricture in both a rat and porcine model. The BTS was manufactured using a terpolymer comprising poly p-dioxanone, trimethylene carbonate, and glycolide. A cohort of 42 rats was randomized into 7 groups of 6 animals each after BTS placement into the duodenum for the biodegradation assay. A total of 12 pigs were randomized equally into a control and BTS placement group. The effectiveness of the BTS was assessed by comparing radiologic images with histologic results. Surgical procedures and/or BTS placements were technically successful in all animals. The median mass losses of the removed BTS samples from the rat duodenum were 2.1, 6.8, 11.2, 19.4, 26.1, and 56.8% at 1, 2, 3, 4, 6, and 8 weeks, respectively. The BTS had completely degraded at 12 weeks in the rats. In the porcine PJ model, the mean luminal diameter and area of the pancreatic duct in the control group was significantly larger than in the BTS group (all
p
< 0.05). BTS placement thus appears to be safe and effective procedure for the prevention of PJ anastomotic stricture. These devices have the potential to be used as a temporary stent placement to treat pancreatic-enteric anastomoses, but further investigations are required for optimization in human.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>32001759</pmid><doi>10.1038/s41598-019-57271-4</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-1408-9048</orcidid><orcidid>https://orcid.org/0000-0001-9114-7750</orcidid><orcidid>https://orcid.org/0000-0002-0614-8271</orcidid><orcidid>https://orcid.org/0000-0003-4552-4169</orcidid><orcidid>https://orcid.org/0000-0002-2533-4491</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | 631/67/1504/1713 639/166/985 692/308/2778 692/308/575 692/4020/1503/1712/1713 Absorbable Implants - veterinary Anastomosis, Surgical - instrumentation Anastomosis, Surgical - methods Animals Biodegradability Biodegradation Constriction, Pathologic - surgery Diabetes mellitus Disease Models, Animal Duodenum Humanities and Social Sciences Implants Male Malnutrition multidisciplinary Pancreas Pancreas - surgery Pancreatic Ducts - surgery Pancreaticoduodenectomy Pancreaticoduodenectomy - adverse effects Pancreaticoduodenectomy - methods Pancreaticojejunostomy Postoperative Complications - surgery Rats Rats, Sprague-Dawley Science Science (multidisciplinary) Stents Stricture Swine |
| title | A Novel Biodegradable Tubular Stent Prevents Pancreaticojejunal Anastomotic Stricture |
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