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. Li, Y., Tang, G., Cheng, Y., Chen, N., Chen, W., & Zhao, J. AJR. American journal of roentgenology, 195(6):1429–1437, December, 2010.
doi  abstract   bibtex   
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.
@article{li_13-year_2010,
	title = {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},
	volume = {195},
	issn = {1546-3141},
	doi = {10.2214/AJR.10.4407},
	abstract = {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.},
	language = {eng},
	number = {6},
	journal = {AJR. American journal of roentgenology},
	author = {Li, Yong-Dong and Tang, Guang-Yu and Cheng, Ying-Sheng and Chen, Ni-Wei and Chen, Wei-Xiong and Zhao, Jun-Gong},
	month = dec,
	year = {2010},
	keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Chi-Square Distribution, Child, Contrast Media, Device Removal, Dilatation, Esophageal Achalasia, Female, Follow-Up Studies, Gastroscopy, Humans, Iohexol, Male, Metals, Middle Aged, Pilot Projects, Prospective Studies, Radiography, Interventional, Statistics, Nonparametric, Stents, Treatment Outcome},
	pages = {1429--1437},
}

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