Predictors of a better outcome of pneumatic dilatation in patients with primary achalasia

• DOI: 10.1007/s00535-009-0145-4
• Publication Date: 2009-11-16T22:33:19Z
• Authors: Yuriko Tanaka; Katsuhiko Iwakiri; Noriyuki Kawami; Hirohito Sano; Mariko Umezawa; Makoto Kotoyori; Yoshio Hoshihara; Tsutomu Nomura; Masao Miyashita; Choitsu Sakamoto
• Keywords: Perforation

Pneumatic dilatation (PD) has been widely used in the treatment of primary achalasia. The aim of this study was to evaluate the effectiveness of PD and its predictive factors in Japanese patients with primary achalasia.Fifty-five consecutive patients were treated using PD (Rigiflex balloon dilator). Diagnosis was established through radiographic and/or esophageal manometry. All patients underwent a pre-designed clinical evaluation prior to and 6 months after PD treatment. We defined success of PD as 6 months or more of clinical remission, with a total score (0-4) or=1 and the score for each item 40-year age group was 85.7%, while the <40-year age group achieved a rate of only 38.5%. Multivariate logistic regression analysis also demonstrated that older age was the only independent factor associated with the success of PD. There was no perforation related to PD.PD is a safe and effective treatment for achalasia, particularly in older patients who experience a better outcome than younger patients.