Cheng YS, Ma F, Li YD, Chen NW, Chen WX, Zhao JG, Wu CG. Temporary self-expanding metallic stents for achalasia: A prospective study with a long-term follow-up. World J Gastroenterol 2010; 16(40): 5111-5117 [PMID: 20976849 DOI: 10.3748/wjg.v16.i40.5111]
Corresponding Author of This Article
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
Article-Type of This Article
Brief Article
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Ying-Sheng Cheng, Fang Ma, Department of Clinical Center of Imaging Medicine, The Tenth Affiliated People’s Hospital, Tongji University, Shanghai 200072, China
Ying-Sheng Cheng, Yong-Dong Li, Jun-Gong Zhao, Chun-Gen Wu, Department of Diagnostic and Interventional Radiology, The Sixth Affiliated People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
Ni-Wei Chen, Wei-Xiong Chen, Department of Gastroenterology, The Sixth Affiliated People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
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.
Supported by The National 9th Five-Year Plan Key Medical Research and Development Program of China, No. 96-907-03-04; Shanghai Natural Science Funds, No. 02Z1314073; Shanghai Medical Development Funds, No. 00419; and the National Natural Science Foundation of China, No. 30670614 and 30970817
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
Telephone: +86-21-66301136 Fax: +86-21-66303983
Received: May 12, 2010 Revised: June 28, 2010 Accepted: July 5, 2010 Published online: October 28, 2010
Abstract
AIM: To compare the efficacy of self-expanding metallic stents (SEMSs) for the long-term clinical treatment of achalasia.
METHODS: 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.
RESULTS: 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.
CONCLUSION: 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.
