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Graded pneumatic dilation in subtype I and II achalasia: long-term experience in a single center

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Ελληνική Γαστροεντερολογική Εταιρία   

Αποθετήριο :
Annals of Gastroenterology   

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Graded pneumatic dilation in subtype I and II achalasia: long-term experience in a single center (EN)
Cortellini, Fabio
Shoshan, Dikla
Azzaroli, Francesco
Torresan, Francesco
Mandolesi, Daniele
De Giorgio, Roberto
Bazzoli, Franco
Mularoni, Cecilia
Ioannou, Alexandros
Karamanolis, George
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
2022-01-10
Background The efficacy of pneumatic dilation (PD) in the management of achalasia has yielded variable results. The availability of high-resolution manometry led to the identification of 3 clinically relevant subtypes of achalasia, revealing the poor efficacy of PD in subtype III. Furthermore, PD showed a lower response rate in patients with subtype III compared to laparoscopic Heller myotomy and peroral endoscopic myotomy. This study aimed to investigate the short- and longterm efficacy, safety profile and side effects of PD with a “graded approach” in subtypes I and II  achalasia. Methods We enrolled 141 patients (male 67, mean age=66±16.26 years) with achalasia (n=27 subtype I, n=74 subtype II and n=40 subtype III) between January 2010 and July 2020 at St. Orsola University Hospital, Bologna, Italy. We analyzed the data of patients with subtypes I and II, who underwent a graded-protocol PD. Short- and long-term clinical efficacy, complications and gastroesophageal reflux disease (GERD) were recorded. Results One month after graded protocol PD, 100% subtype I and 96.2% subtype II achalasia patients showed clinical remission. The PD procedure was completed without major complications in all patients. In the long-term follow up (median time: 56 months), 95.5% subtype I and 90% subtype II achalasia patients had an Eckardt score ≤3. GERD occurred in 27.7% of all patients. Conclusion A graded-protocol PD applied in the appropriate achalasia subtypes was shown to be a safe and highly effective approach, in both the short- and long-term. Keywords Esophageal achalasia, pneumatic dilation, Heller myotomy, endoscopic gastrointestinal surgery, high-resolution manometry Ann Gastroenterol 2022; 35 (1): 28-33 (EN)
Αγγλική γλώσσα
Hellenic Society of Gastroenterology (EN)
1792-7463
1108-7471
Annals of Gastroenterology; Volume 35, No 1 (2022); 28 (EN)
Copyright (c) 2022 Annals of Gastroenterology (EN)
Ελληνική Γαστροεντερολογική Εταιρία
Annals of Gastroenterology
Original Articles



*Η εύρυθμη και αδιάλειπτη λειτουργία των διαδικτυακών διευθύνσεων των συλλογών (ψηφιακό αρχείο, καρτέλα τεκμηρίου στο αποθετήριο) είναι αποκλειστική ευθύνη των αντίστοιχων Φορέων περιεχομένου.