Experience with the Witzel Type Pneumatic Dilator in the Treatment of Achalasia of the Esophagus
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Although pneumatic dilation has been an established treatment for achalasia for decades, there is limited information about its long-term efficacy. Methods: 43 patients (12 f, 32m, 27-70ys) with achalasia were prospectively studied during a 4-year period. All patients were investigated before, 4 weeks after and 12 months (final visit) after pneumatic dilation. Initial symptomatic success was obtained in 37 patients of 43 patients (86%). The remaining 6 patients with recurrent dysphagia underwent a second dilation, and one of these underwent esophagomyotomy. Effective dilation was reflected by a significant decrease of the symptom score (P <0.01 ) and an increase of the gastric cardia diameter both at 4 weeks after dilation and at the fmal visit (P < 0.01 ). Dilation reduced the lower esophageal sphincter pressure from 27.3±0.8 mmHg to 143±5.3 mmHg at the 4 weeks examination and to 145±53 mmHg at the final visit, respectively (P < 0.01 ). Two patients got submucosal haematoma after dilation and no reported perforation, Conclusion : Pneumatic dilation with low compliance balloon (Witzel Type) proved to be a safe and long lasting treatment of achalasia.