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
| Autor: | Yong-Dong Li, Wei-Xiong Chen, Jun-Gong Zhao, Guang-Yu Tang, Ying-Sheng Cheng, Ni-Wei Chen |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Iohexol medicine.medical_treatment Contrast Media Achalasia Pilot Projects Radiography Interventional Statistics Nonparametric Group B Gastroscopy medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Clinical efficacy Child Clinical treatment Device Removal Aged Aged 80 and over Pneumatic dilation Chi-Square Distribution Esophageal disease business.industry Stent General Medicine Middle Aged medicine.disease Dilatation Surgery Esophageal Achalasia Treatment Outcome Metals Female Stents Remission rate business Follow-Up Studies |
| Zdroj: | American Journal of Roentgenology. 195:1429-1437 |
| ISSN: | 1546-3141 0361-803X |
| DOI: | 10.2214/ajr.10.4407 |
| Popis: | 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.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.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.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. |
| Databáze: | OpenAIRE |
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