Efficacy and safety of pneumatic balloon dilation in achalasia: a 12-year experience

Kurtcehajic, Admir; Salkić, Nermin N.; Alibegovic, Ervin; Hujdurovic, Ahmed; Kurtcehajic, Dzenita; Križić, Nataša

doi:10.1007/s10388-014-0458-0

Cited by 3 publications

(3 citation statements)

References 33 publications

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“…On the other hand, the main histopathologic changes resulting from achalasia related to Triple A Syndrome are fibrosis of the inner muscular plane and neuronal nitric oxide synthase deficiency[ 10 ]. As a result, pneumatic dilation (PD) is not effective over the long term with long-term efficacy decreasing to 40%-50%[ 11 , 12 ] leading to severe fibrosis from repeated muscle tears which is the major reason of perforation[ 13 , 14 ]. While two patients with achalasia related to Triple A syndrome have been treated a single time with PD and experienced symptom alleviation within a year[ 15 ], there is still little evidence confirming the efficacy of this treatment over the long term.…”

Section: Discussionmentioning

confidence: 99%

Triple A syndrome-related achalasia treated by per-oral endoscopic myotomy: Three case reports

Liu¹,

Feng²,

Yang³

et al. 2022

WJCC

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BACKGROUND Triple A syndrome is a rare autosomal recessive disease characterized by adrenocorticotropic hormone-resistant adrenal insufficiency, alacrima and achalasia. In the last 5 years, per-oral endoscopic myotomy (POEM) has proved highly successful in treating primary achalasia over the long term, but its long-term performance has not been certified by achalasia related to Triple A syndrome. CASE SUMMARY Triple A syndrome is a rare autosomal recessive disease characterized by adrenocorticotropic hormone-resistant adrenal insufficiency, alacrima and achalasia. In the past 5 years, POEM has proved highly successful in treating primary achalasia over the long term, but its long-term performance has not been certified by achalasia related to Triple A syndrome. Eckardt scores and esophageal manometry improved significantly during the 2 years following POEM; however, grade-A reflux esophagitis recurred in 66.7% of patients in 12 mo post-procedure. CONCLUSION Based on these case studies, POEM is efficacious and safe for a treatment of achalasia associated with Triple A syndrome.

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Section: Discussionmentioning

confidence: 99%

Triple A syndrome-related achalasia treated by per-oral endoscopic myotomy: Three case reports

Liu¹,

Feng²,

Yang³

et al. 2022

WJCC

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“…PD has been considered the most effective nonsurgical method in the treatment of esophageal achalasia, including the cost–benefit ratio in this analysis, when taking into account the first 5–10 years of the disease's therapeutic care …”

Section: Introductionmentioning

confidence: 99%

“…2 PD has been considered the most effective nonsurgical method in the treatment of esophageal achalasia, including the cost-benefit ratio in this analysis, when taking into account the first 5-10 years of the disease's therapeutic care. 3,4 However, over the years, there has been no shortage of controversy regarding several methodological features of PD: the choice of the appropriate dila-tor, the gauge of the balloon, the speed with which it should be inflated, the pressure that should be reached, the length of time to maintain it inflated, the number of dilations per endoscopic session, the number of sessions and the interval between them, not to mention the discussion about whether or not the patient needs to be admitted, even if just for a short period, whether the patient needs to be sedated, and the choice of said sedative. Each medical center has its own preferences.…”

Section: Introductionmentioning

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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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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