Efficacy and safety of endoscopic-guided balloon dilatation without fluoroscopy for the treatment of achalasia

Abstract

© 2018, Medical Association of Thailand. All rights reserved. Background: Achalasia is a primary esophageal motor disorder of unknown etiology. One of the standard treatments is pneumatic balloon dilatation under fluoroscopic guidance. Endoscopic-guided balloon dilatation without fluoroscopy can also be performed, but the efficacy and associated safety issues remain unclear. Objective: To assess efficacy and safety of endoscopic-guided balloon dilatation technique for achalasia treatment at Maharaj Nakorn Chiang Mai Hospital. Materials and Methods: This study is a retrospective, descriptive study in achalasia patients who were initially diagnosed and treated with the endoscopic-guided balloon dilatation technique between January 2007 and December 2012. Achalasia symptoms before and after treatment were evaluated to assess the efficacy. Immediate complications and long term follow- up were used to assess safety of this method. Results: Sixteen eligible achalasia patients who underwent the dilatation under endoscopic guidance were included in the analysis. There was a significant improvement in Eckardt score from 6.6±1.9 to 0.5±0.7 (p-value <0.001). All patients (100%) had improvement in dysphagia symptoms and gained weight after the dilatation procedure. No serious complications were observed. Conclusion: Endoscopic guided pneumatic balloon dilatation as an initial treatment of achalasia is a safe technique and has a high level of efficacy.