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Temporary self‐expanding cardia stents for the treatment of achalasia: an experimental study in dogs
Author(s) -
Zhu Y.q.,
Cheng Y.s.,
Li M.h.,
Zhao J.g.,
Li F.,
Chen N.w.
Publication year - 2010
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/j.1365-2982.2010.01573.x
Subject(s) - stent , achalasia , esophageal sphincter , medicine , esophageal stent , nuclear medicine , surgery , urology , gastroenterology , esophagus , disease , reflux
Background To assess the performance, efficiency and optimal removal time of a newly designed temporary retrievable cardia covered stent (TRC‐CS) for the treatment of achalasia in a dog model. Methods Eighty‐four achalasia‐like dog models were randomly divided into seven groups of 12, a control group (CG; no stent insertion), a standard stent control group (NSCG, standard esophageal stent) and five treatment groups (TG, TRC‐CS). Stents were retrieved at 4 days after insertion in the NSCG and at 4 days(4 d‐TG), 2 weeks(2 w‐TG), 1 month(1 m‐TG), 3 months(3 m‐TG), and 6 months(6 m‐TG) in the TGs. Lower esophageal sphincter pressure (LESP) and a timed barium esophagram were assessed before stent insertion, after stent retrieval, and at 1‐week, 1‐, 3‐ and 6‐month follow‐up. Three dogs in NSCG and 4 d‐TG were sacrificed for histological examination at each follow‐up to investigate the inflammatory reaction after stent insertion. Key Results Stent insertion/removal and the follow‐up procedures were well tolerated. At 6‐month follow‐up, the 2 w‐TG and 1 m‐TG demonstrated an acceptable stent migration ( n = 2 in both TGs vs n = 4 in NSCG, n = 4 in 3 m‐TG, and n = 6 in 6 m‐TG), improved LESP compared to after benzyl‐dimethyltetradecylammonium chloride (BAC) injection ( P < 0.05), and improved timed barium height ( P = 0.0144 and 0.0409). Mouse –proliferating cell nuclear antigen (PCNA) and α‐smooth muscle actin staining revealed no inflammatory reaction difference between the NSCG and 4 d‐TG at each follow‐up. Conclusions & Inferences The TRC‐CS was effective in the treatment of achalasia in a dog model. LESP measurements, timed barium esophagram studies suggest an optimal stent retrieval time of between 2 w∼1 m.