Temporary self-expanding metallic stents for achalasia: a prospective study with a long-term follow-up

To compare the efficacy of self-expanding metallic stents (SEMSs) for the long-term clinical treatment of achalasia. Ninety achalasic patients were treated with a temporary SEMS with a diameter of 20 mm (n = 30, group A), 25 mm (n = 30, group B) or 30 mm (n = 30, group C). Data on clinical symptoms,...

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Published inWorld journal of gastroenterology : WJG Vol. 16; no. 40; pp. 5111 - 5117
Main Authors Cheng, Ying-Sheng, Ma, Fang, Li, Yong-Dong, Chen, Ni-Wei, Chen, Wei-Xiong, Zhao, Jun-Gong, Wu, Chun-Gen
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Co., Limited 28.10.2010
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Summary:To compare the efficacy of self-expanding metallic stents (SEMSs) for the long-term clinical treatment of achalasia. Ninety achalasic patients were treated with a temporary SEMS with a diameter of 20 mm (n = 30, group A), 25 mm (n = 30, group B) or 30 mm (n = 30, group C). Data on clinical symptoms, complications and treatment outcomes were collected, and follow-up was made at 6 mo and at 1, 3-5, 5-8, 8-10 and > 10 years, postoperatively. Stent placement was successful in all patients. Although chest pain occurrence was high, stent migration was less in group C than in groups A and B. The clinical remission rate at 5-8, 8-10 and > 10 years in group C was higher than that in the other two groups. The treatment failure rate was lower in group C (13%) than in groups A (53%) and B (27%). SEMSs in group C resulted in reduced dysphagia scores and lowered esophageal sphincter pressures, as well as normal levels of barium height and width during all the follow-up time periods. Conversely, these parameters increased over time in groups A and B. The primary patency in group C was longer than in groups A and B. A temporary SEMS with a diameter of 30 mm is associated with a superior long-term clinical efficacy in the treatment of achalasia compared with a SEMS with a diameter of 20 mm or 25 mm.
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Correspondence to: Dr. Chun-Gen Wu, Department of Diagnostic and Interventional Radiology, The Sixth Affiliated People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China. chengys@sh163.net
Author contributions: Cheng YS, Li YD and Wu CG contributed equally to this work; Cheng YS, Chen NW and Chen WX designed the research and performed the research; Li YD, Ma F and Zhao JG offered new reagents/analytic tools; Li YD and Zhao JG analyzed data; Li YD and Ma F wrote the paper.
Telephone: +86-21-66301136 Fax: +86-21-66303983
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v16.i40.5111