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

作     者：Ying-Sheng Cheng Fang Ma Ying-Sheng Cheng Yong-Dong Li Jun-Gong Zhao Chun-Gen Wu Ni-Wei Chen Wei-Xiong Chen 

作者机构：Department of Clinical Center of Imaging Medicine The Tenth Affiliated People’s Hospital Tongji University Shanghai 200072 China Department of Diagnostic and Interventional Radiology The Sixth Affiliated People’s Hospital Shanghai Jiao Tong University Shanghai 200233 China Department of GastroenterologyThe Sixth Af��liated People’s HospitalShanghai Jiao Tong UniversityShanghai 200233China 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2010年第16卷第40期

页      面：5111-5117页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：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 the National Natural Science Foundation of China, No. 30670614 and 30970817 

主　　题：Achalasia Dysphagia Self-expanding metallic stents Comparison 

摘      要：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, ***: 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.