Pneumatic balloon dilation in achalasia: a prospective comparison of balloon distention time.
OBJECTIVE
Duration of Inflation in pneumatic balloon dilatation as treatment of achalasia has been variable ranging from 15 s to 6 min. A 60 s duration appears to be most often used. We compared the efficacy of dilation of achalasia with either 6- or 60-s inflation duration using a Rigiflex dilator of 3.0 cm diameter.


METHODS
Eighty-one consecutive patients were prospectively studied in a randomized fashion, 41 in the 60-s group (A) and 40 patients in the 6-s group (B). Mean age of group A was 43 +/- 16.2 yr and of group B was 40 +/- 16.4 yr. Symptoms of dysphagia, chest pain, heartburn, regurgitation, and night cough were evaluated at basal (before dilation), 1- and 6-month intervals after dilation in both groups. Barium swallow was done to assess esophageal emptying 1 wk before dilation and 5 min postdilation in both groups.


RESULTS
Significant and sustained improvement was seen for all symptoms in both groups. In addition, the degree of improvement in symptom scores between the two groups was similar. Barium esophagram in both groups at basal and immediately postdilation showed significant improvement in barium emptying but there was no significant difference between the two groups, indicative of equal efficacy in both distention times. Two patients needed repeat dilatation in group A and one in group B, with one drop out from group A, who was lost to follow-up, and was excluded from the analysis. No perforation occurred.


CONCLUSIONS
Short duration of pneumatic balloon dilatation (6-s) is as effective as longer duration (60-s) in treatment of achalasia.
Khan
A A
AA
Department of Gastroenterology, Shaikh Zayed Postgraduate Medical Institute, Lahore, Pakistan.
Shah
S W
SW
Alam
A
A
Butt
A K
AK
Shafqat
F
F
Castell
D O
DO
D000328:Adult; D000388:Air; D000704:Analysis of Variance; D001466:Barium Sulfate; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D002637:Chest Pain / Q000503:physiopathology / Q000628:therapy; D003287:Contrast Media; D003371:Cough / Q000503:physiopathology / Q000628:therapy; D003680:Deglutition Disorders / Q000503:physiopathology / Q000628:therapy; D004931:Esophageal Achalasia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000503:physiopathology / Q000628:therapy; D006356:Heartburn / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D010528:Peristalsis / Q000502:physiology; D011446:Prospective Studies; D011859:Radiography; D019233:Retreatment; D016037:Single-Blind Method; D013997:Time Factors
D003287:Contrast Media; D001466:Barium Sulfate