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Clinical Remission in Endoscope-Guided Pneumatic Dilation for the Treatment of Esophageal Achalasia: 7-Year Follow-up Results of a Prospective Investigation

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background and Aims

Prospective, long-term reports and predictors of outcome of endoscope-guided pneumatic dilation are lacking in the literature. The aim of this prospective 7-year follow-up study is to report the efficacy of endoscope-guided pneumatic dilation and determine the possible confounding factors related to remission.

Methods

Between January 1998 and June 2004, 32 patients were enrolled. Each patient was treated with endoscope-guided pneumatic dilation and followed-up at regular intervals for a median of 4.5 years. Remission was determined with the use of a structured interview and a previously described symptom score. Cumulative remission rate was analyzed by using the Kaplan–Meier method with assessment of symptom scores between grades before and after PD at 6 weeks, 6 months, 1 year, and then every year after. Possible confounding factors related to the remissions were analyzed by Cox’s proportional hazard model.

Results

Complete follow-up until August 2007 was obtained in 100% of all patients. Cumulative remissions were 1 year (86.7%), 2 years (86.7%), 3 years (80.0%), 4 years (76.5%), 5 years (72.9%), 6 years (61.7%), and 7 years (61.7%), respectively. Age is a relevant confounding factor to the remissions showing a worse outcome for those under 45 (p = 0.046). One esophageal perforation occurred (3.3%).

Conclusions

Endoscope-guided PD itself is safe and modestly effective for up to 7 years investigations in current study. Older patients (>45 years) have favorable overall clinical remissions.

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Acknowledgment

The authors would like to acknowledge Miss Chih-Yun Lin for statistical analysis.

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Authors and Affiliations

  1. Division of Hepato-gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital—Kaohsiung Medical Center, 123, Ta-Pei Road, Niao-sung Hsiang, Kaohsiung County, 833, Taiwan, Republic of China

    Seng-Kee Chuah, Tsung-Hui Hu, Keng-Liang Wu, Wei-Chen Tai, Yi-Chun Chiu, Chuan-Mo Lee & Chi-Sin Changchien

  2. Division of Hepato-gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan, Republic of China

    Seng-Kee Chuah, Tsung-Hui Hu, Keng-Liang Wu, Wei-Chen Tai, Yi-Chun Chiu, Chuan-Mo Lee & Chi-Sin Changchien

  3. Division of Gastroenterology, Veteran General Hospital, Kaohsiung, Taiwan, Republic of China

    Ping-I Hsu

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  1. Seng-Kee Chuah
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  2. Tsung-Hui Hu
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Correspondence to Seng-Kee Chuah.

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Chuah, SK., Hu, TH., Wu, KL. et al. Clinical Remission in Endoscope-Guided Pneumatic Dilation for the Treatment of Esophageal Achalasia: 7-Year Follow-up Results of a Prospective Investigation. J Gastrointest Surg 13, 862–867 (2009). https://doi.org/10.1007/s11605-009-0804-z

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  • DOI: https://doi.org/10.1007/s11605-009-0804-z

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