Predictors of Successful Balloon Dilation in Patients with Achalasia - Especially in patients who showed peristalsis after dilation

Song, Chul Soo; Yu, Young Il; Park, Seung Keun; Kang, Dae Hwan; Song, Geun Am; Cho, Mong; Yang, Ung Suk

Abstract

OBJECTIVES
Achalasia is primary esophageal motility disorder characterized by aperistalsis in body and incomplete lower esophageal sphincter(LES) relaxation. The aim of this study was to evaluate the parameters of successful balloon dilatation predicting long term outcome
METHODS
17 patients with primary esophageal achalasia from March 1995 to December 1996 were included in this study. 5 patients were performed re-balloon dilatation due to recurrence of symptoms. We used Rigiflex Achalasia Balloon with diameter of 30 and 35mm and balloon is dilated for 1 minute at a 5 minute interval. Esophageal manometry and scintigraphy before and after 1 month of balloon dilation were compared between groups with good long term results and relapsed
RESULTS
1) After balloon dilatation, LES pressure, basal esophageal pressure and retention rate were significantly decreased 2) After 6 months of dilatation, 12 patients were successfully treated and 5 patients were recurred 3) No significant pre-dilatation parameters were found to predict the recurrence 4) After 1 month of dilatation, patients with recurrence of symptoms showed significant higher LES pressure and retention rate 5) 2 patients showed recovery of the peristasis, and in these patients, amplitude of esophageal body contraction of pre- and post-balloon dilatation were significantly high
CONCLUSION
After 1 month of dilatation, LES pressure and retention rate can predict the outcome after balloon dilatation and high amplitude of esophageal body contraction predict recovery of peristalsis and long term good result