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Pneumatic Balloon Dilation Therapy Is as Effective as Esophagomyotomy for Achalasia

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Abstract

For many years different treatments have been used for achalasia. However, esophagomyotomy (ESM) and pneumatic balloon dilation (PBD) have been considered the treatments of choice. Despite new research, some controversies still exist. We compared patients who underwent open ESM (n = 19) with those who underwent PBD (n = 45). Data on age, gender, pre- and postprocedure symptoms, clinical manifestations at the time of research, clinical relief, type of surgery, and costs were collected via questionnaire. Open ESMs were performed by two expert surgeons, and PBDs were performed by one gastroenterologist. There was no significant difference in clinical symptoms and in patient satisfaction between the groups before and after the procedures except for chest pain. Clinical relief status (excellent, good, moderate, or poor) was comparable (26%, 42%, 15%, 15% for open ESM group and 40%, 20%, 24%, 15% for PBD group). Postprocedure complications were not significantly different between the two groups. Clinical rates of relapse for open ESM and PBD groups were 38.6% and 25%, respectively. There were no serious complications. There was no significant difference between the clinical outcomes of the two methods of achalasia treatment. Considering other important factors such as a shorter period of hospitalization, fewer sick days off, risk of general anesthesia, and cosmetic sequels, PBD is preferable for the majority of patients.

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Acknowledgment

This work was supported by: Isfahan University of Medical Science and Poursina Hakim Research Institution. The authors thank Amir Hossein Zangi Abadi MD, Amitice Bahramian MD, Ali Shekarchi Zade MD, Abbas Esmaeili MD, Mandana Soleymani MS for their superb assistance in this project.

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Authors and Affiliations

  1. Isfahan University of Medical Science, Isfahan, Iran

    Mohammad Hassan Emami, Abbas Tabatabai, Mehran Haghighi, Hamid Tavakoli, Mozafar Hashemi, Mehdi Fude, Ziba Farajzadegan & Vahid Goharian

  2. Poursina Hakim Research Institution, Isfahan, Iran

    Mohammad Hassan Emami, Mostafa Raisi, Jaleh Amini, Hamid Tavakoli & Ziba Farajzadegan

  3. Poursina Research Institution, No. 9 Behesht Building, Bozorgmehr Av., Isfahan, Iran

    Mostafa Raisi

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  1. Mohammad Hassan Emami
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  2. Mostafa Raisi
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  3. Jaleh Amini
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Correspondence to Mostafa Raisi.

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Emami, M.H., Raisi, M., Amini, J. et al. Pneumatic Balloon Dilation Therapy Is as Effective as Esophagomyotomy for Achalasia. Dysphagia 23, 155–160 (2008). https://doi.org/10.1007/s00455-007-9115-2

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  • DOI: https://doi.org/10.1007/s00455-007-9115-2

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