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. |
