Application of novel biomaterials in endoscopic submucosal dissection

doi:10.3877/cma.j.issn.2095-2015.2023.03.008

Abstract

Abstract:

Endoscopic submucosal dissection(ESD)is widely used in the early diagnosis and treatment of gastrointestinal tumors.However, ESD may cause iatrogenic ulcers and be accompanied by complications such as bleeding and perforation.The existing treatment measures after ESD, such as the application of the antacids and the mucosa protectors have certain limitations, and there are also shortcomings of electrocoagulation and hemostatic clips.Therefore, advanced wound management measures are needed to promote postoperative wound healing and prevent complications.We review the application and mechanism of novel biomaterials in ESD according to literatures for the past few years, in order to promote the further related research.

Key words: Endoscopic submucosal dissection, Biomaterials, Complications

Han Liu, Hui Li, Yuxin Zhu, Miao Yu, Wanying Li, Shuang Wang, Yuzhu Di, Dandan Ning, Bo Qu. Application of novel biomaterials in endoscopic submucosal dissection[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(03): 167-171.

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URL: https://zhxhbyyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2015.2023.03.008

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材料	作用	优点	缺点
壳聚糖^{[5,19,20,21,22,23,41]}	抗菌、药物传递、促进创面愈合	价格便宜、易修饰、生物可降解、临床应用广泛	需要对力学性能进行修饰及验证、加入交联剂后需要进行生物相容性验证
聚乙烯亚胺/聚丙烯酸粉^[24]	止血，促进创面愈合	物理性能优越	体内生物相容性、生物降解性尚待验证
氨基己酸聚合物^[25,26,27]	止血、药物传递、促进创面愈合、防止瘢痕挛缩	可抑制创面过度纤维化，防止瘢痕狭窄	力学性能欠佳，需要加入交联剂改进
自组装肽^[28,29,30]	止血、促进创面愈合	生物可降解、已有产品投入内镜黏膜下剥离术后的临床应用	凝胶化速度较慢，黏附强度相对较小，需要冷藏
胶原蛋白类^[31,32,33]	防止瘢痕挛缩、促进创面愈合	操作简单，抑制创面过度纤维化，防止瘢痕狭窄	缺乏远期疗效的评估
小肠黏膜下层提取物^[34,35]	保护创面、减轻创面炎症	生物可吸收	物理阻碍会导致创面愈合延迟

材料	作用	优点	缺点
壳聚糖^{[5,19,20,21,22,23,41]}	抗菌、药物传递、促进创面愈合	价格便宜、易修饰、生物可降解、临床应用广泛	需要对力学性能进行修饰及验证、加入交联剂后需要进行生物相容性验证
聚乙烯亚胺/聚丙烯酸粉^[24]	止血，促进创面愈合	物理性能优越	体内生物相容性、生物降解性尚待验证
氨基己酸聚合物^[25,26,27]	止血、药物传递、促进创面愈合、防止瘢痕挛缩	可抑制创面过度纤维化，防止瘢痕狭窄	力学性能欠佳，需要加入交联剂改进
自组装肽^[28,29,30]	止血、促进创面愈合	生物可降解、已有产品投入内镜黏膜下剥离术后的临床应用	凝胶化速度较慢，黏附强度相对较小，需要冷藏
胶原蛋白类^[31,32,33]	防止瘢痕挛缩、促进创面愈合	操作简单，抑制创面过度纤维化，防止瘢痕狭窄	缺乏远期疗效的评估
小肠黏膜下层提取物^[34,35]	保护创面、减轻创面炎症	生物可吸收	物理阻碍会导致创面愈合延迟

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