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VOLUME 7 , ISSUE 2 ( July-December, 2017 ) > List of Articles

ORIGINAL ARTICLE

Pneumatic Balloon Dilatation for Achalasia Cardia: Outcome, Complications, Success, and Long-term Follow-up

Sudhir J Gupta, Nitin R Gaikwad, Amol R Samarth, Sonal R Gattewar

Citation Information : Gupta SJ, Gaikwad NR, Samarth AR, Gattewar SR. Pneumatic Balloon Dilatation for Achalasia Cardia: Outcome, Complications, Success, and Long-term Follow-up. Euroasian J Hepatogastroenterol 2017; 7 (2):138-141.

DOI: 10.5005/jp-journals-10018-1234

License: CC BY 3.0

Published Online: 01-08-2018

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Background

Achalasia is a chronic disease that can be managed with effective endoscopic modalities.

Aim

To evaluate the effectiveness of single setting of pneumatic balloon dilatation for achalasia and assess the long-term success and outcomes.

Materials and methods

This is a retrospective study of all achalasia patients who underwent pneumatic balloon dilatation at our institute. Patients who could be contacted were inquired regarding their symptoms and dysphagia-free interval after dilatation.

Results

A total of 72 patients were enrolled. Out of this, 14 patients lost to follow-up. Mean age of 58 patients was 45.02 ± 16.51 years. Male:female ratio was 13:16. Mean predilatation Eckardt score was 7.16 ± 0.834. Type I achalasia was present in 10 (17.2%), type II in 44 (75.9%), type III in 4 (6.9%). Predilatation basal integrated relaxation pressure (IRP) was 28.14 ± 14.76 mm Hg. Postdilatation Eckardt score was 2.40 ± 1.67. Postdilatation dysphagia-free interval was 17.28 ± 6.70 months. A total of 9 patients (15.51%) failed to respond to first dilatation and 49 (84.48%) patients benefited from single setting of pneumatic dilatation. Esophageal perforation occurred in 2/58 (3.44%). We did not find any significant difference in gender distribution, age of presentation, duration of symptom, pre- and postdilatation Eckardt score, type of achalasia, and basal IRP on manometry between type of achalasia. Postdilatation dysphagia-free interval in type II achalasia (18.09 ± 5.976 months) was more than types I and III achalasia cardia (p = 0.066), which showed trend toward significance.

Conclusion

Pneumatic balloon dilatation of achalasia cardia is a highly effective endoscopic procedure with minimal complications and mortality. Even the single setting of dilatation can have long-lasting dysphagia-free interval.

How to cite this article

Gupta SJ, Gaikwad NR, Samarth AR, Gattewar SR. Pneumatic Balloon Dilatation for Achalasia Cardia: Outcome, Complications, Success, and Long-term Follow-up. Euroasian J Hepato-Gastroenterol 2017;7(2):138-141.


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  1. ; Friedman LS.; Brandt LJ. Sleisenger and Fortran's gastroenterological and liver disease. 9th ed. Philadelphia (PA): Saunders Elsevier; 2010.
  2. Achalasia: update on the disease and its treatment. Gastroenterology 2010 Aug;139(2):369-374.
  3. The American Society for Gastrointestinal Endoscopy PIVI (Preservation and Incorporation of Valuable Endoscopic Innovations) on peroral endoscopic myotomy. Gastrointest Endosc 2015 May;81(5):1087.e1-1100.e1.
  4. ACG clinical guideline: diagnosis and management of achalasia. Am J Gastroenterol 2013 Aug;108(8):1238-1249, quiz 1250.
  5. Achalasia—a disease of unknown cause that is often diagnosed too late. Dtsch Arztebl Int 2012 Mar;109(12):209-214.
  6. Long-term follow-up after pneumatic dilation for achalasia cardia: factors associated with treatment failure and recurrence. Am J Gastroenterology 2004 Dec;99(12):2304-2310.
  7. The value of scoring achalasia: a comparison of current systems and the impact on treatment—the surgeon's viewpoint. Am Surg 2007 Apr;73(4):327-331.
  8. AGA technical review on the clinical use of esophageal manometry. Gastroenterology 2005 Jan;128(1):209-224.
  9. Achalasia: a new clinically relevant classification by high-resolution manometry. Gastroenterology 2008 Nov;135(5):1526-1533.
  10. The Chicago classification for achalasia in a French multicentric cohort. Dig Liver Dis 2012 Dec;44(12):976-980.
  11. Clinical and manometric effects of nifedipine in patients with esophageal achalasia. Gastroenterology 1981 Jan;80(1):39-44.
  12. Management of achalasia: surgery or pneumatic dilation. Gut 2011 Jun;60(6):869-876.
  13. Long-term outcome of pneumatic dilation in the treatment of achalasia. Clin Gastroenterol Hepatol 2010 Jan;8(1):30-35.
  14. The long-term efficacy of pneumatic dilatation and Heller myotomy for the treatment of achalasia. Clin Gastroenterol Hepatol 2006 May;4(5):580-587.
  15. Pneumatic dilation versus laparoscopic Heller's myotomy for idiopathic achalasia. N Engl J Med 2011 May;364:1807-1816.
  16. The cost of laparoscopic myotomy versus pneumatic dilatation for esophageal achalasia. Surg Endosc 2007 Jul;21(7):1198-1206.
  17. The lower oesophageal sphincter. Neurogastroenterol Motil 2005 Jun;17(Suppl 1):13-21.
  18. Outcomes of treatment for achalasia depend on manometric subtype. Gastroenterology 2013 Apr;144(4):718-725.
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