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Korean J Gastrointest Endosc. 2002 Oct;25(4):187-191. Korean. Original Article.
Sym SJ , Jung HY , Jo CL , Ji HS , Park TI , Park SR , Kim AY , Myung SJ , Ryu JS , Yang SK , Ha HK , Hong WS , Kim JH , Min YI .
Department of Internal Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea. hyjung@amc.seoul.kr
Department of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
Department of Nuclear Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
Abstract

BACKGROUND/AIMS: Pneumatic dilation is the most effective non-surgical treatment option for the patients with achalasia. The aim of this study was to determine the predictors of outcome after pnematic dilation in patients with primary achalasia. METHODS: Thrity-five patients with primary achalasia between May 1996 and April 2001 were included. They were divided into two groups; responder and nonresponder. Esophageal manometry, scintigraphy and barium esophagogram was performed before dilation and 4 weeks after dilation. RESULTS: Seven patients having symptomatic relapse were treated with repeated pneumatic dilation. Remaining 28 patients (83%) had no recurrence during follow-up period (mean duration 16 month, range 6~43 month). Among the factors evaluated in the initial examination, only young age affected outcome (p=0.039). The post treatment retention fraction at 5, 20 minutes were the most valuable factors for predicting the clinical response (p<0.05). CONCLUSIONS: Older patients are more likely to have sustained response. Radionuclide esophageal emptying test remains a useful objective study evaluating esophageal transit before and after pneumatic dilation in the patients with achalasia and may have an important role in the follow-up evaluation of treatment for achalasia.

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