Application of the newly developed stents in the treatment of benign cardia stricture: an experimental comparative study.
BACKGROUND
Retrievable temporary stent placement has recently been suggested as a potential treatment for benign esophageal stricture.


OBJECTIVE
To assess the efficacy of a newly designed cardia stent for the treatment of benign cardia stricture in a canine model compared with groups that received pneumatic dilation or standard esophageal stent insertion.


METHODS
Basic experimental study.


METHODS
GI interventional center.


METHODS
Forty-eight dog models were randomly divided into a control group (no stent insertion) (n=12), a pneumatic dilation group (PDG) (n=12), a standard esophageal stent group (SESG) (n=12), and a novel cardia stent group (NCSG) (n=12).


METHODS
Pneumatic dilation, standard esophagus stent, cardia stent.


METHODS
Lower esophageal sphincter pressures and the 5-minute barium height were assessed before and immediately after the procedure, after 1 week, and at 1-, 3-, and 6-month follow-up. Three dogs in each group were killed for histological examination.


RESULTS
Stent insertion was tolerated by all dogs, with a lower migration rate in the NCSG (0% vs 41.7% in the SESG; P=.0373). At the 6-month follow-up, the lower esophageal sphincter pressure and 5-minute barium height values in the NCSG were still stable compared with those in the PDG and SESG (P<.05). Immunohistochemistry for mouse anti-proliferating cell nuclear antigen and α-smooth muscle actin revealed a stronger inflammatory reaction peak in the PDG than in the SESG and NCSG (P<.05). Collagen proliferation was most severe after 6 months in the PDG (P<.05).


CONCLUSIONS
Longer follow-up studies are required to assess whether the recurrence rate is lower because of less inflammation and scarring.


CONCLUSIONS
The novel cardia stent was more effective than pneumatic dilation or a standard stent in this canine model.
Department of Radiology, The Sixth Affiliated People's Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.
Yue-Qi
YQ
Zhu
Ying-Sheng
YS
Cheng
Feng
F
Li
Ming-Hua
MH
Li
Jun-Gong
JG
Zhao
Ni-Wei
NW
Chen
D000818:Animals; D002299:Cardia / Q000601:surgery*; D004195:Disease Models, Animal; D004285:Dogs; D004940:Esophageal Stenosis / Q000601:surgery*; D005260:Female; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome