Esophageal achalasia: comparison of fluoroscopically-guided double vs. endoscopically-guided single balloon dilation.
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.
Yi
Ann
A
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.
Shin
Ji Hoon
JH
Song
Ho-Young
HY
Jung
Hwoon-Yong
HY
Lee
Gin Hyug
GH
Yoon
Chang Jin
CJ
Choi
Eugene
E
Kim
Kyung-Rae
KR
Kim
Jin Hyoung
JH
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
D018686:Anesthetics, Intravenous; D003287:Contrast Media; D008874:Midazolam