Summary
The long-term prognosis of expanding bag dilatation therapy using a Matsuo pneumatic bag dilator was evaluated in 163 cases of esophageal achalasia treated by this method over the 26-year period from 1964 to 1989. In all these cases, one year or more had passed since therapy. Practically no correlation was found between the efficacy of the therapy and the grade of esophageal dilation prior to therapy, the previous history of symptomatic distress or the number of dilatations performed. The efficacy of expanding bag cardial dilatation was most obvious in the increase of body weight, 59 cases (36.2%) showing an increase of 1–5 kg and 48 cases (29.4%) showing an increase of 6–10 kg. The therapy was rated “highly effective” in 61 cases (37.4%) and “effective” in 60 cases (36.8%), i.e. it was effective in a total of 121 cases (74.2%). It was rated as being “ineffective” in 16 cases (9.8%) including 4.3% of cases in which an operation had been performed. This indicated that surgical operation of esophageal achalasia should be performed in those cases in which good long-term results were not obtained even after expanding bag dilatation therapy had been carried out several times.
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References
Willis T. Pharmacentice rationalis sive diatriba medicamentorum operationibus in humano corpore. London: Hagoe-Comitis, 1674; 330.
Rake GW. A case of annular muscular hypertrophy of the esophagus. Guy’s Hosp Rep 1926;76:145–152.
Okinaka S, Nakao Y, Yoshikawa M. Digestive disease. Idiopathic dilatation of the esophagus. Autonomous nervous system and clinical medicine. Tokyo: Kyorin Shoin, 1964;117–122.
Castell DO, Herris LD. Hormonal control of gastroesophageal sphincter strength. N Engl J Med 1970;282:886–889.
Giles GR, Mason MC, Humphries C, et al. Action of gastrin on the lower esophageal sphincter in man. Gut 1969;10:730–734.
Cohen S, Lipshutz W, Hughes W. Role of gastrin supersensitivity in the pathogenesis of lower esophageal sphincter hypertension in achalasia. J Clin Invest 1971;50:1241–1247.
Matsuo Y, Seki A, Mori H, et al. Some findings in cardial dilatation therapy of esophageal achalasia. Jpn J Gastroenterol 1974;71: 1200–1201. (in Japanese)
Heller E. Extramukose cardioplastik beim chronischen cardiospasmus mit dilatation des Oesophagus. Mitt Grenzgeb Med Chir 1913;27:141–149.
Barrett NR, Franklin RH. Concerning the unfavorable late results of certain operations performed in the treatment of cardiospasm. Br J Surg 1949;37:194–202.
Olson AM, Harrington SW, Moersch HJ, et al. The treatment of cardio spasm. Analysis of a twelve year experience. J Thoracic Surg 1951;22:164–187.
Mogen HG. Tratamiento de la achalasia del cardias. Gastroenterol 1956;86:179–182.
Schindler R. Observations on cardiospasm and its treatment by brusque dilatation. Ann Intern Med 1956;45:207–215.
Nanson EM. Treatment of cardiospasm by the expanding bag technique. Can Med Assoc J 1962;86:1107–1111.
Van Goidsenhoven GE, Vantrappen G, Verbeke S, et al. Treatment of achalasia of the cardia with pneumatic dilation. Gastroenterology 1963;45:326–334.
Nakayama K. Fundamental and clinical studies on idiopathic dilatation of the esophagus. (II) Clinical studies. Jpn J Gastroenterol 1962;59:788–794. (in Japanese)
Sato H. Studies on the cause and clinical features of idiopathic dilatation of the esophagus. The Journal of the 17th General Assembly of the Japan Medical Congress 1967;862–865.
Akakura I, Nakamura Y, Imai Y. Achalasia of the esophagus. Pathophysiology and follow-up study on patients undergone esophago-myotomy. The proceedings of the 3rd world congress of gastroenterology 1966; 1:330–333.
Honda K, Chiba A, Kato K, et al. Treatment of achalasia. Jpn J Thorac Surg (Kyobugeka) 1968;21:152–161.
Okamoto E, Nanba M. Congenital stenosis of the esophagus and achalasia. J Jpn Soc Pediatr Surg 1968;4:26–30.
Matsuo Y. Achalasia and its treatment. Jpn J Clin Med (Nippon Rinsho) 1968;26:2688–2689.
Matsuo Y. Forced cardial dilatation therapy. Jpn J Clin Med (Nippon Rinsho) 1970;28:908–909.
Matsuo Y. Achalasia. Intern Med (Naika) 1971;27:1012–1016.
Matsuo Y. Achalasia. J Jpn Med Assoc 1971;66:945–949.
Matsuo Y. The use of pharmacotherapy in various diseases. Achalasia. J Therap (Chiryo) 1973;55:1961–1962.
Matsuo Y, Seki A, Kitamura T. Long-term results of pneumatic bag cardial dilatation therapy in achalasia. J Clin Exp Med (Igaku no Ayumi) 1975;92:22–29.
Matsuo Y. Achalasia. Today’s Therapy 1980;22:280–281.
Matsuo Y. Esophageal achalasia. Efficacy of cardial dilatation therapy. Diagn Treat (Shindan to Chiryo) 1981;69:536–539.
Matsuo Y. Achalasia. J Jpn Med Assoc 1983;89:1744–1745.
Matsuo Y. Achalasia. Practice of internal medicine. Tokyo: Igaku Shoin, 1987;271–272.
Matsuo Y. Esophageal achalasia. Today’s Therapy 1988;30:363–364.
Pope II CE. Disorders of smooth muscle. Achalasia. Gastrointestinal disease. Third Edition. Philadelphia: WB Saunders Co, 1983;430–439.
Thomas R. Hendrix MD. Achalasia. Current therapy in gastroenterology and liver disease, 1984–1985. Philadelphia: BC Decke Inc, 1984;28–32.
Ouyang A, Cohen S. Motor disorders of the esophagus. Achalasia. Bockus Gastroenterology. Philadelphia: WB Saunders Co, 1985; 695–700.
Sauer L, Pellegrini CA, Way LW. The treatment of achalasia. A current perspective. Arch Surg 1989;124:929–931.
Barkin JS, Guelrud M, Reiner DK, et al. Forceful balloon dilation. An outpatient procedure for achalasia. Gastrointest Endosc 1990; 36:123–126.
Baumann R, de Peyer R, Dederding JP, et al. Treatment of achalasia using balloon dilatation. Schweiz Med Wochenschr 1990;120: 1304–1307.
McJunkin B, McMillan WO Jr, Duncan HE Jr, et al. Assessment of dilatation methods in achalasia. Large diameter mercury bougienage followed by pneumatic dilation as needed. Gastrointest Endosc 1991;37:18–21.
Ferguson MK. Achalasia. Current evaluation and therapy. Ann Thorac Surg 1991;52:336–342.
Adams H, Roberts GM, Smith PM. Oesophageal tears during pneumatic balloon dilatation for the treatment of achalasia. Clin Radiol 1989;40:53–57.
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Matsuo, Y., Sugimura, F. & Seki, A. Long-term prognosis of patients with achalasia treated by cardial dilatation therapy. Gastroenterol Jpn 27, 719–727 (1992). https://doi.org/10.1007/BF02806524
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DOI: https://doi.org/10.1007/BF02806524