Mid term results of pneumatic balloon dilatation in patients with achalasia

Abstract

AIM: In this retrospective study we report the mid term results of a single center in patients with primary achalasia undergoing balloon dilatation. Methods: Between April 1997 and May 2007, 82 patients with primary symptomatic achalasia (diagnosed by clinical presentation, manometry, esophagoscopy, and barium esophagogram) underwent endoscopic balloon dilatation. They were followed up clinically for 1 year after the last session. Results : Symptoms were dysphagia (n = 82, 100%), regurgitation (n = 13, 16%), chest pain (n = 4, 8%), and weight loss (n = 36, 43%). A total of 98 dilatations were performed; 68 patients (83%) underwent a single dilatation, 12 (15%) required a second procedure within a median of 1,7 mo (range 0.8- 2,0 mo), and only 2 patients, (2%) who were poor surgical candidates underwent a third procedure. Post-procedural seven of the 12 patients with no improvement after the second dilatation were considered for surgical myotomy and they were lost to follow up. Seven patients (5.4%) had esophageal pain and one patient had upper gastrointestinal bleeding. No perforations occurred. After one year 58 of the 75 remaining patients (78%) were in clinical remission, 10 (13%) presented the same symptomatology and only 7 patients (9%) deteriorated. Conclusion:Balloon dilatation is a safe and effective treatment for primary achalasia.