ISSN:
1573-2568
Keywords:
PNEUMATIC DILATATION
;
ACHALASIA
;
ESOPHAGUS
;
ESOPHAGEAL MOTILITY DISORDERS
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Although pneumatic dilatation (PD) has been anestablished treatment for achalasia for decades, thereis limited information on its long-term clinicalefficacy. We have followed up the clinical status of patients having PD with a 30- or 35-mm balloonby one of us (D.O.C.) over a 25-year period. Of 144patients whose initial records were available forreview, 31 could not be contacted. Of the remaining 113 patients, 72 (64%) responded to a questionnaireassessing swallowing status and patient satisfaction,and this forms the basis of this report. There were 32men and 40 women, with mean age 46 years (range: 17-78); mean length of follow-up since PD was6.5 years (range: 10 months to 25 years). Success wasprimarily defined by the need for no additional therapyfor achalasia other than one or two PD's. PD was effective long-term treatment in 61/72 patients(85% ); only four of these required a second PD overthis time interval. There was no significant differencein any of the following parameters between patients with a treatment success or failure: age, sex,size of pneumatic dilator, and duration of symptomsprior to PD. Response was significantly better (P 〈0.05) in patients having no prior dilatation (43/47; 91%) than in those in whom another physicianhad performed prior dilatation (18/25; 72%). In responseto the question of whether they would select PD again,68 patients (94%) responded positively. In conclusion, pneumatic dilatation performedusing a consistent technique by an experienced physicianis effective long-term therapy for achalasia patients ofall ages. Most patients require only onedilatation.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1018886626144
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