Dilatación neumática en el tratamiento de pacientes con acalasia

Cuesta, Patricia Ruiz; Molina, A.; García, Juan Jurado; Navarro, María Pleguezuelo; Sánchez, V. García; Juanena, Luis Leonardo Casáis; Calderón, Carmen; Rodriguez, A

doi:10.1016/j.gastrohep.2013.05.009

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…It has been previously shown that the initial results of forced dilatation of the cardia are effective and similar in chagasic or nonchagasic achalasia . The success rates, providing control of dysphagia for at least about 1 year from the procedure using the Rigiflex balloon, are quite satisfactory, with success in at least 75% of patients (Table ) …”

Section: Results Of Pneumatic Dilation In Achalasiamentioning

confidence: 98%

“…32 The success rates, providing control of dysphagia for at least about 1 year from the procedure using the Rigiflex balloon, are quite satisfactory, with success in at least 75% of patients (Table 2). 11,[33][34][35][36][37][38][39][40][41] This was already expressed in a review of 21 studies, where success rates reached 74%, 80%, and 90% using balloons of 30, 35, and 40 mm in diameter, respectively. 42 However, this positive view of using a larger caliber balloon for better results is diminished when it is observed in another publication that, starting with 35 mm balloons, four perforations occurred in the first 13 patients with achalasia submitted to PD, meaning that the protocol had to be adjusted so that the procedure always started with a 30-mm balloon, slowly increasing the gauge if necessary.…”

Section: Results Of Pneumatic Dilation In Achalasiamentioning

confidence: 99%

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Results of pneumatic dilation in treating achalasia: predictive factors

Felix

2018

Annals of the New York Academy of Sciences

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Forced pneumatic dilatation (PD) of the cardia is one of the most consecrated therapeutic measures for esophageal achalasia. The procedure only achieved better standardization with the appearance of the Rigiflex balloon. Results and predictive factors of success and failure of PD are reviewed, right after the description of the main technical aspects of the procedure. The success rates, providing control of dysphagia for about 1 year from the procedure using the Rigiflex balloon, are quite satisfactory, with success in more than 75% of patients. It is generally observed that good responses sustained for more than 5 years appear in at least 40% of cases. However, approximately half of the patients submitted to PD require additional dilation and a subgroup of them will undergo surgical treatment to attain adequate control of dysphagia. PD is a method with a low rate of acute complications, with esophageal perforation, the most severe of them, not affecting more than 5% of the cases. The best results could be potentially obtained when predictive factors of success were considered before choosing PD as a therapeutic option, but prospective studies in this field are missing until now.

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Section: Results Of Pneumatic Dilation In Achalasiamentioning

confidence: 98%

Section: Results Of Pneumatic Dilation In Achalasiamentioning

confidence: 99%

Results of pneumatic dilation in treating achalasia: predictive factors

Felix

2018

Annals of the New York Academy of Sciences

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“…Though pneumatic dilation (PD) is currently the preferred treatment for achalasia, multiple sessions are required in some patients. 3 Peroral endoscopic myotomy (POEM), as a non-inferior modality to Heller's myotomy, has been applied during the past decade as a minimally invasive, effective, and safe endoscopic therapy for patients with achalasia. 4,5 The 5-year clinical success rate is over 90% after POEM or Heller's myotomy in patients with achalasia.…”

Section: Introductionmentioning

confidence: 99%

A comprehensive analysis of partial peristalsis recovery after peroral endoscopic myotomy in patients with achalasia

Liang

Yang

et al. 2023

J of Digest Diseases

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Objective: To determine whether peroral endoscopic myotomy (POEM) improves esophageal peristalsis and to investigate the association between recovery of esophageal peristalsis after POEM and clinical features of the patients. Methods: In this single-center retrospective study, data were collected from medical records of the patients with achalasia who underwent POEM between January 2014 and May 2016. Demographics data, high-resolution esophageal manometry parameters, Eckardt score, and gastroesophageal reflux disease questionnaire (GERD-Q) score were collected. Weak and fragmented contraction was defined as partial recovery of esophageal peristalsis based on the Chicago classification version 3.0. Logistic regression analysis was used to identify variables associated with the partial recovery of peristalsis after POEM.Results: A total of 103 patients were enrolled. Esophageal contractile activity was observed in the distal two-thirds of the esophagus in 24 patients. The Eckardt score, integrated relaxation pressure, and lower esophageal sphincter (LES) resting pressure were significantly decreased after POEM. Multivariate analysis revealed that preprocedural LES resting pressure (P = 0.013) and preprocedural Eckardt score (P = 0.002) were related to the partial recovery of peristalsis after POEM. Symptoms of gastroesophageal reflux and reflux esophagitis after POEM were less frequent in those with partial recovery of peristalsis (both P < 0.05).Conclusions: Normalization of esophagogastric junction relaxation pressure achieved by POEM is associated with the partial recovery of esophageal peristalsis in patients with achalasia. Preprocedural LES resting pressure and the Eckardt score are predictive of the recovery of esophageal peristalsis.

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