Abstract:Objective To develop a biodegradable anti-reflux stent used for the esophagogastric anastomosis after esophagectomy. Methods A biodegradable anti-reflux stent was designed and developed by 3D printing technology using polylactic acid(PLA) materials. Anti-reflux valve was prepared inside the stent with bovine pericardium. The in vitro degradation characteristics of the stent was determined by bioremediation experiment in the in vitro simulated gastric acid environment. The cardiectomy at the lower segment of the esophagus and esophagogastric anastomosis were performed in 6 pigs. The feasibility and safety of the esophagogastric anastomosis stent were observed during and after the operation. Results The valve stent was successfully developed by 3D printing technology. The biodegradation experiment in vitro showed that the stent was gradually degraded within 16 weeks with a slow speed. The in vivo experiments showed that the early postoperative eating needed not gastric tube drainage in the pigs. The healing of the anastomotic was good after 4 weeks without anastomotic fistula or stenosis, however, 1 patient had pyloric obstruction after the operation and the stent residues were still in the gastric cavity after 4 weeks. Conclusion The developed biodegradable anti-reflux anastomosis stent has the advantages of simple and quick operation, definite anastomosis and early feeding without gastric tube drainage. However, the degradation of the anastomosis stent is slow at the risk of pyloric obstruction, and further improvement is needed.
