title: Esophageal achalasia: comparison of fluoroscopically-guided double vs. endoscopically-guided single balloon dilation.
abstract: OBJECTIVE
  To compare the long-term clinical effectiveness of fluoroscopically guided double and endoscopically guided single balloon dilations in esophageal achalasia.
  
  
  METHODS
  Thirty-two fluoroscopically guided balloon dilations were performed in 21 patients (group A) and 48 endoscopically guided balloon dilations were performed in 37 patients (group B). The double balloon dilation technique (10 + 20-mm, 15 + 20-mm or 20 + 20-mm in diameter), with preceding single balloon dilation (10, 15, or 20-mm in diameter), was used in group A, whereas the single balloon dilation technique (30, 35, or 40-mm in diameter) with gradually increased internal pressure was used in group B. Technical success, clinical success, complications, and primary/secondary patency rates were compared between the two groups.
  
  
  RESULTS
  All procedures were technically successful without esophageal perforation. Clinical success was achieved in 97% (31/32) and 92% (44/48) of balloon dilations in groups A and B, respectively. The symptomatic improvement in dysphagia was significantly higher in group A than in group B. Incidence of complications was the same (18.8%) in both groups. Group A showed significantly longer primary and secondary patency periods than did group B (P < 0.05).
  
  
  CONCLUSIONS
  Fluoroscopically guided double balloon dilation has greater long-term effectiveness than endoscopically guided single balloon dilation in the treatment of esophageal achalasia.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-2dong, Songpa-gu, Seoul, 138-736, South Korea.
authors.forename: Ann
authors.initials: A
authors.lastname: Yi
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Shin
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Song
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
authors.forename: Gin Hyug
authors.initials: GH
authors.lastname: Lee
authors.forename: Chang Jin
authors.initials: CJ
authors.lastname: Yoon
authors.forename: Eugene
authors.initials: E
authors.lastname: Choi
authors.forename: Kyung-Rae
authors.initials: KR
authors.lastname: Kim
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D016292:Procedural Sedation / Q000379:methods; D003287:Contrast Media / Q000008:administration & dosage; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D004931:Esophageal Achalasia / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D012189:Retrospective Studies; D013995:Time; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D003287:Contrast Media; D008874:Midazolam