Reply to Dong et al.
(2019) Endoscopy — Vol. 51, n° 7, p. 700 (2019)
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- On behalf of all co-authors, we would like to thank Professor Fan and his colleagues for their thoughtful comments regarding our paper. In the following, these comments will be briefly addressed. First, Fan et al. correctly point out that biodegradable stents were effective in reducing the number of dilations in the first 3 months, but overall endoscopic procedures were not decreased over this period compared with the dilation group [1]. This was mainly due to the fact that, in the first 3 months, some patients experienced retrosternal pain and food bolus obstruction. Regarding the latter, patients receiving a stent should be instructed that, although patency is established, it is important to follow an adapted diet (i. e. eating slowly, chewing thoroughly, and drinking fluids during the meal) to prevent obstruction. Regarding retrosternal pain, this has been reported with different types of stents, particularly in the first few days or week, after which it usually diminishes or disappears [2]. In our institution, we inform patients before stent placement about this possible adverse event and send them home with easily accessible analgesic medication. Moreover, we only perform diagnostic endoscopy when the pain persists for a longer period despite medication. However, in this multicenter study, some centers had a policy of performing diagnostic endoscopy at an earlier stage. [...]
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Walter, D., van den Berg, M. W., Hirdes, M. M., Vleggaar, F. P., Repici, A., Deprez, P., Viedma, B. L., Lovat, L. B., Weusten, B. L., Bisschops, R., Haidry, R., Ferrara, E., Sanborn, K. J., O’Leary, E. E., van Hooft, J. E., & Siersema, P. D. (2019). Reply to Dong et al. Endoscopy, 51(7), 700. https://doi.org/10.1055/a-0919-4867 (Original work published 2019)