Efficacy of implantation of a modified temporary metallic stent for cardia achalasia / 中华消化内镜杂志

ABSTRACT

Objective To study the efficacy and safety of implantation of a modified temporary self-expanding metallic stent for cardia achalasia.Methods A total of 30 patients diagnosed as having cardia achalasia were randomly divided into 2 groups,group A (traditional stents) and group B (modified stents)(n =15 in each group).Two days after stent implantation at the cardia by endoscopy,stents were withdrawn with endoscope guided by X-ray.LES Pressure,X-ray images ( including the diameter of the most dilated part of esophageal and the most narrow part of cardia) and the symptoms of dysphagia were compared before and half year after the treatment.The width changes of the most narrow stenting part on the point of stenting and 2 days after removal were compared.The side effects and complications during the treatment were recorded.Results All thirty stents were successfully implanted and removed.Stent dislocation occured in 2 cases in group A,but none in group B.Dysphagia had significant improvement after the treatment in both groups ( P ＜ 0.05 ),but the recurrence rate of group A ( 26.7％ ) was significantly higher than group B (6.67％ ) in 6 months ( P ＜ 0.05 ).LES pressure and X-ray images of both groups significantly improved after treatment ( P ＜ 0.001 ),and those of group B were superior to group A ( P ＜ 0.05 ).There was no difference in adverse reaction between the two groups.No perforation occured in any group.Conclusion Self-expanding metallic stents is safe for patients with cardia achalasia,with implantation convenience,symptomatic improvement,low recurrence,and few complications or dislocation.