Comparison of endoscopic balloon dilation with metal stent placement in the treatment of achalasia

Zhao, Hang; Wan, Xin; Yang, Chang

doi:10.1111/1751-2980.12241

Cited by 14 publications

(12 citation statements)

References 23 publications

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“…Endoscopic botulinum toxin injection is safe and effective in aged patients, but the effect tends to attenuate over time, and repeated treatment is thus needed (9). Stent insertion is an alternative, and has demonstrated the same effective as PD, however the longterm efficacy is not that satisfactory and stent migration also occurs (10).…”

Section: Discussionmentioning

confidence: 99%

Peroral endoscopic myotomy versus pneumatic dilation for achalasia in patients aged = 65 years

Wang¹,

Tan²,

Lv³

et al. 2016

Rev Esp Enferm Dig

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Background and aim: Both peroral endoscopic myotomy (POEM) and pneumatic dilation (PD) has proved to be effective for treating achalasia in patients aged ≥ 65 years. However little is known about the comparison between POEM and PD. The aim of the study was to compare the safety and efficacy of POEM and PD for the treatment of achalasia in these patients.Methods: We retrospectively reviewed the medical records of patients aged 65 years-old or more who received POEM or PD for the treatment of achalasia at our hospital from January 2010 to December 2015, they were divided into the POEM group and the PD group. Demographics and data about safety and efficacy were collected retrospectively and compared between the two groups.Results: A total of 31 patients were enrolled, and 21 of them received POEM, while the other 10 received PD. The treatment success (Eckardt score ≤ 3) rate of POEM and PD at 3, 6, 12, 24 and 36 months after the treatment were comparable (p > 0.05). Treatment failure was noticed in 3 cases, 1 of them was in the POEM group and the other 2 in the PD group, there was no significant difference (p > 0.05). Multivariate analysis showed that sigmoid-type achalasia was a predictive factor of treatment failure. No severe complications were observed during operation and periodical follow-up.Conclusion: Short-term and intermediate efficacy of POEM and PD for treating achalasia in patients aged ≥ 65 years was comparable. A large scale, randomized study with long-term follow-up is necessary in order to make a definitive conclusion.

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Section: Discussionmentioning

confidence: 99%

Peroral endoscopic myotomy versus pneumatic dilation for achalasia in patients aged = 65 years

Wang¹,

Tan²,

Lv³

et al. 2016

Rev Esp Enferm Dig

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“…There are several conditions, both congenital and acquired (malignant or benign tumor, in some forms of atresia, caustic lesion, and severe reflux), for which esophageal replacement is needed [1]. The surgical intervention remains the preferred treatment, however alternative options are essential for restoring esophageal continuity and functionality [2][3][4][5]. These alternative approaches may be associated with several complications, such as inflammatory response, scar deposition, stricture formation, and in the most serious cases, they could cause the morbidity of surrounding tissues [6].…”

Section: Introductionmentioning

confidence: 99%

Tissue Engineered Esophageal Patch by Mesenchymal Stromal Cells: Optimization of Electrospun Patch Engineering

Pisani

Croce

Chiesa

et al. 2020

IJMS

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Aim of work was to locate a simple, reproducible protocol for uniform seeding and optimal cellularization of biodegradable patch minimizing the risk of structural damages of patch and its contamination in long-term culture. Two seeding procedures are exploited, namely static seeding procedures on biodegradable and biocompatible patches incubated as free floating (floating conditions) or supported by CellCrownTM insert (fixed conditions) and engineered by porcine bone marrow MSCs (p-MSCs). Scaffold prototypes having specific structural features with regard to pore size, pore orientation, porosity, and pore distribution were produced using two different techniques, such as temperature-induced precipitation method and electrospinning technology. The investigation on different prototypes allowed achieving several implementations in terms of cell distribution uniformity, seeding efficiency, and cellularization timing. The cell seeding protocol in stating conditions demonstrated to be the most suitable method, as these conditions successfully improved the cellularization of polymeric patches. Furthermore, the investigation provided interesting information on patches’ stability in physiological simulating experimental conditions. Considering the in vitro results, it can be stated that the in vitro protocol proposed for patches cellularization is suitable to achieve homogeneous and complete cellularizations of patch. Moreover, the protocol turned out to be simple, repeatable, and reproducible.

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“…91,92 On the other hand, as the risk and complexity of oesophageal resection increases with the deterioration of a patient's condition and nutritional status, end-stage achalasia should be carefully followed up to identify promptly when oesophagectomy is necessary. Several studies have investigated the use of alternative therapies such as oesophageal stents [93][94][95][96][97][98][99][100][101] and intrasphincteric injection with ethanolamine oleate in achalasia treatment. [102][103][104][105] Overall, there is no high-quality evidence to support that either of these therapies is effective for symptom relief in achalasia patients.…”

Section: How To Treat Recurrence Post Poemmentioning

confidence: 99%

European guidelines on achalasia: United European Gastroenterology and European Society of Neurogastroenterology and Motility recommendations

et al. 2020

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Introduction Achalasia is a primary motor disorder of the oesophagus characterised by absence of peristalsis and insufficient lower oesophageal sphincter relaxation. With new advances and developments in achalasia management, there is an increasing demand for comprehensive evidence-based guidelines to assist clinicians in achalasia patient care. Methods Guidelines were established by a working group of representatives from United European Gastroenterology, European Society of Neurogastroenterology and Motility, European Society of Gastrointestinal and Abdominal Radiology and the European Association of Endoscopic Surgery in accordance with the Appraisal of Guidelines for Research and Evaluation II instrument. A systematic review of the literature was performed, and the certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation methodology. Recommendations were voted upon using a nominal group technique. Results These guidelines focus on the definition of achalasia, treatment aims, diagnostic tests, medical, endoscopic and surgical therapy, management of treatment failure, follow-up and oesophageal cancer risk. Conclusion These multidisciplinary guidelines provide a comprehensive evidence-based framework with recommendations on the diagnosis, treatment and follow-up of adult achalasia patients.

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Comparison of endoscopic balloon dilation with metal stent placement in the treatment of achalasia

Abstract: Balloon dilation and removable stents can effectively relieve clinical manifestations in patients with achalasia.

Cited by 14 publications

References 23 publications

Peroral endoscopic myotomy versus pneumatic dilation for achalasia in patients aged = 65 years

Peroral endoscopic myotomy versus pneumatic dilation for achalasia in patients aged = 65 years

Tissue Engineered Esophageal Patch by Mesenchymal Stromal Cells: Optimization of Electrospun Patch Engineering

European guidelines on achalasia: United European Gastroenterology and European Society of Neurogastroenterology and Motility recommendations

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