Achalasia cardia: A study of 113 patients managed with indigenous dilator.
BACKGROUND
Endoscopic dilatation of achalasia cardia is an effective nonsurgical management option. It requires costly pneumatic dilators which are used under fluoroscopic guidance. This study assesses the efficacy and safety of an indigenous pneumatic dilator used without fluoroscopic guidance.


METHODS
Over a period of eleven years, 113 patients (69M, 44F) ofachalasia cardia underwent dilatation with indigenous pneumatic dilators without fluoroscopic guidance. The dilatation was performed under endoscopic vision.


RESULTS
The procedure was successful in all patients. After six weeks following dilatation, there was significant improvement in the mean dysphagia score 3.63 + 0.61 to 0.53 + 0.93 (P<0.01). The response was still significant (0.78 + 1.03, P <0.05) at the end of one year. Excellent response with single dilatation was seen in 70.7% patients. After two dilatation sessions 92% of patients showed an excellent response. One patient had perforation. There was no mortality.


CONCLUSIONS
Pneumatic dilatation under endoscopic vision without fluoroscopic assistance with the indigenous dilator is very effective and safe for short term treatment of achalasia carida.
Nijhawan
S
S
Department of Gastroenterology, SMS. Medical College and Hospital, Jaipur. dr_nijhawan@yahoomail.com
Mathur
A
A
Kumar
D
D
Tandon
M
M
Rastogi
M
M
Joshi
A
A
Shende
A
A
Agarwal
N
N
Rai
R R
RR
D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D004724:Endoscopy; D004931:Esophageal Achalasia / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged