MIKAELI J, MALEKZADEH R, KHATIBIAN M, ANSARI R, VAHEDI H, SOLIMANI H. GRADED P NEUMATIC DILATATION WI THOUT FLUOROSCOPY IN THE T REATMENT OF ESOPHAGEAL ACHALASIA. Med J Islam Repub Iran 2000; 14 (1) :15-18
URL:
http://mjiri.iums.ac.ir/article-1-893-en.html
From the Department of Gastroenterology and Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, I.R. Iran
Abstract: (4343 Views)
Between 1993-1996 seventy-three consecutive patients (33 M, 40 F, mean age
35.4) with newly diagnosed achalasia underwent one or more pneumatic dilatations
with the Rigiflex balloon using a protocol of graded dilatation with a fixed inflation
pressure of 10 psi and constant duration of 30 seconds for all patients without using
fluoroscopy. Using Vantrappen's classification for assessment of response, excellent
or good results were considered as cure and fair or poor results as failure. Duration
of symptoms and the amount of weight loss before dilatation averaged 5.2 years
and 10 kg, respectively. In 62 patients one, in 5 patients two, and in 4 patients three
dilatations were performed. Dilatation failed in one patient because of previous
surgery and was followed by perforation in one patient (1.4%) and bleeding in
another patient (1.4%). Follow up period averaged 20 months (range 6-38 months)
with a cure rate of 90% (57 excellent, 9 good) and failure rate of 6.8% (3 fair, 2
poor). We conclude that graded pneumatic dilatation without fluoroscopy is a safe
and very effective treatment for achalasia with 90% of patients having a sustained
response lasting at least for an average of 20 months.