Document Detail


13-year follow-up of a prospective comparison of the long-term clinical efficacy of temporary self-expanding metallic stents and pneumatic dilatation for the treatment of achalasia in 120 patients.
MedLine Citation:
PMID:  21098206     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this article is to compare the efficacy of self-expanding metallic stents and pneumatic dilation for the long-term clinical treatment of achalasia.
SUBJECTS AND METHODS: Patients diagnosed with achalasia (n = 120) were allocated for treatment with pneumatic dilation (n = 30; group A) or a temporary self-expanding metallic stent with a diameter of 20 mm (n = 30; group B), 25 mm (n = 30; group C), or 30 mm (n = 30; group D). Data on clinical symptoms, complications, and long-term clinical outcomes were collected, and follow-up was performed at 6 months and at 1, 3-5, 5-8, 8-10, and more than 10 years after surgery.
RESULTS: Pneumatic dilation and stent placement were technically successful in all patients. The follow-up at more than 10 years revealed that the clinical remission rate in group D (83.3%) was higher than that in groups A (0%), B (0%), and C (28.6%), and the overall cumulative clinical failure rate in group D (13%) was lower than that in groups A (76.7%), B (53.3%), and C (26.7%). Patients in group D exhibited reduced dysphagia scores and lower esophageal sphincter pressures and had normal levels of barium height and width during the follow-up periods, whereas these markers increased with time in the other groups. The duration of primary patency in group D was also longer than that in groups A, B, and C.
CONCLUSION: A temporary self-expanding metallic stent with a diameter of 30 mm has superior clinical efficacy for the treatment of achalasia compared with pneumatic dilation or self-expanding metallic stents with diameters of 20 or 25 mm.
Authors:
Yong-Dong Li; Guang-Yu Tang; Ying-Sheng Cheng; Ni-Wei Chen; Wei-Xiong Chen; Jun-Gong Zhao
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  195     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1429-37     Citation Subset:  AIM; IM    
Affiliation:
Department of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Child
Contrast Media / administration & dosage
Device Removal
Dilatation / methods
Esophageal Achalasia / therapy*
Female
Follow-Up Studies
Gastroscopy
Humans
Iohexol / administration & dosage,  analogs & derivatives
Male
Metals
Middle Aged
Pilot Projects
Prospective Studies
Radiography, Interventional / methods*
Statistics, Nonparametric
Stents*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Metals; 66108-95-0/Iohexol; 73334-07-3/iopromide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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