Long-term outcome of pneumatic dilation in the treatment of achalasia.
OBJECTIVE
Achalasia is a well-defined esophageal motor disorder for which pneumatic dilation is an established therapeutic method. Even though it has been used for several years, there are limited data on the long-term outcomes of patients treated with this procedure. Hence, we aimed to evaluate the long-term efficacy of pneumatic dilation to control the symptoms of achalasia.


METHODS
The medical records of all patients treated in our unit for achalasia with pneumatic dilation were reviewed. We identified the long-term result of the initial procedure, the date of the first dilation, and the time interval between dilation and retreatment.


RESULTS
Of 260 patients who were treated with pneumatic dilation, 153 (67 men, 86 women) were followed up for more than 5 yr. The mean follow-up period was 11.09 +/- 3.91 yr, and the success rate of the dilation was 75.8%. Among these patients, 35 (19 men, 16 women) had follow-up periods of more than 15 yr. The mean follow-up time of those patients was 16.56 +/- 1.09 yr, and the success rate was 51.4%. Kaplan-Meier survival analysis showed that, overall, 50% of patients develop recurring symptoms after 10.92 yr.


CONCLUSIONS
Although 51.4% of patients continued to be in clinical remission more than 15 yr after the initial pneumatic dilation, the long-term success rate of pneumatic dilation seems to drop progressively with time.
Karamanolis
Georgios
G
Gastroenterology Unit, Athens Naval and Veterans Hospital, 3 Monis Kikkou, 15669 Papagou, Athens, Greece.
Sgouros
Spiros
S
Karatzias
Georgios
G
Papadopoulou
Efthimia
E
Vasiliadis
Konstantinos
K
Stefanidis
Gerasimos
G
Mantides
Apostolos
A
D002404:Catheterization / Q000009:adverse effects; D004931:Esophageal Achalasia / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome