Clinical remission following endoscopic placement of retrievable, fully covered metal stents in patients with esophageal achalasia.

Abstract

Metal stents may represent an alternative therapy in the treatment of achalasia. We therefore evaluated the effectiveness of retrievable, fully covered metal stents in patients with achalasia. Fifty-nine patients with achalasia were treated with retrievable, fully covered metal stents. Symptoms using a global symptom score (0-10), lower esophageal sphincter (LES) resting pressure, LES relaxation, and simultaneous contraction of the esophagus were analyzed before and 1 week and 1 month after intervention. Complications and treatment outcomes were followed up at 6, 12, 18, and 24 months postoperatively. Stent placement was successful, and clinical symptoms resolved (P < 0.01) in all patients. Regurgitation, dysphagia and chest pain improved significantly (all P < 0.01). Therapy improved LES resting pressure (51.4 ± 9.7 mmHg pretherapy vs. 20.9 ± 8.1 mmHg post-therapy), LES relaxation (58.1 ± 17.1% pretherapy vs. 84.5 ± 18.9% post-therapy), and simultaneous contraction of the esophagus (36.1 ± 8.6% pretherapy vs. 69.4 ± 23.1% post-therapy) 1 month after stent placement (all P < 0.01). The cumulative clinical remission rates 6, 12, 18, 24, 30, and 36 months after stent removal were 90.9%, 81.8%, 76.4%, 69.1%, 65.5%, and 49.1%, respectively. All patients tolerated stent placement. Twelve patients (25.5%) complained of substernal pain and five (10.6%) had substernal burning. Stents migrated in four patients (8.5%). Insertion of retrievable, fully covered metal stents is an effective and safe treatment in patients with achalasia.

• Authors: Y Zeng, Y-M Dai, X-J Wan
• Journal: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus (Dis Esophagus) 2014 Feb-Mar Vol. 27 Issue 2 Pg. 103-8 ISSN: 1442-2050 [Electronic] United States
• PMID: 23796127 (Publication Type: Journal Article)
• Copyright: © 2013 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

Chemical References

• Metals

Topics

• Adult
• Aged
• Cohort Studies
• Deglutition Disorders (etiology, surgery)
• Esophageal Achalasia (complications, surgery)
• Female
• Humans
• Male
• Manometry
• Metals
• Middle Aged
• Prospective Studies
• Prosthesis Failure
• Remission Induction (methods)
• Stents
• Treatment Outcome