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Esophageal achalasia: comparison of fluoroscopically-guided double vs. endoscopically-guided single balloon dilation

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Abstract

Purpose

To compare the long-term clinical effectiveness of fluoroscopically guided double and endoscopically guided single balloon dilations in esophageal achalasia.

Materials and methods

Thirty-two fluoroscopically guided balloon dilations were performed in 21 patients (group A) and 48 endoscopically guided balloon dilations were performed in 37 patients (group B). The double balloon dilation technique (10 + 20-mm, 15 + 20-mm or 20 + 20-mm in diameter), with preceding single balloon dilation (10, 15, or 20-mm in diameter), was used in group A, whereas the single balloon dilation technique (30, 35, or 40-mm in diameter) with gradually increased internal pressure was used in group B. Technical success, clinical success, complications, and primary/secondary patency rates were compared between the two groups.

Results

All procedures were technically successful without esophageal perforation. Clinical success was achieved in 97% (31/32) and 92% (44/48) of balloon dilations in groups A and B, respectively. The symptomatic improvement in dysphagia was significantly higher in group A than in group B. Incidence of complications was the same (18.8%) in both groups. Group A showed significantly longer primary and secondary patency periods than did group B (P < 0.05).

Conclusion

Fluoroscopically guided double balloon dilation has greater long-term effectiveness than endoscopically guided single balloon dilation in the treatment of esophageal achalasia.

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Acknowledgment

This study was supported by a grant (2004-312) from the Asan Institute for Life Sciences, Seoul, Korea.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-2dong, Songpa-gu, Seoul, 138-736, South Korea

    Ann Yi, Ji Hoon Shin, Ho-Young Song, Kyung-Rae Kim & Jin Hyoung Kim

  2. Department of Internal Medicine, University of Ulsan College of Medicine Asan Medical Center, Seoul, South Korea

    Hwoon-Yong Jung & Gin Hyug Lee

  3. Department of Radiology, Bundang Seoul National University Hospital, College of Medicine, Seoul National University, Seongnam, South Korea

    Chang Jin Yoon

  4. Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA

    Eugene Choi

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  1. Ann Yi
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  2. Ji Hoon Shin
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  3. Ho-Young Song
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  4. Hwoon-Yong Jung
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  5. Gin Hyug Lee
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  6. Chang Jin Yoon
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  7. Eugene Choi
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  8. Kyung-Rae Kim
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  9. Jin Hyoung Kim
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Corresponding author

Correspondence to Ji Hoon Shin.

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None of the authors have identified a potential conflict of interest.

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Yi, A., Shin, J.H., Song, HY. et al. Esophageal achalasia: comparison of fluoroscopically-guided double vs. endoscopically-guided single balloon dilation. Abdom Imaging 33, 177–182 (2008). https://doi.org/10.1007/s00261-007-9199-z

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  • DOI: https://doi.org/10.1007/s00261-007-9199-z

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