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Review article: an analysis of the efficacy, perforation rates and methods used in pneumatic dilation for achalasia
Alimentary Pharmacology and Therapeutics, 08/19/2011
Review Article
Clinical Article
Katzka DA et al. – The response for a single dilation session was 66% at 1 year and 59, 53, 50 and 25% at 2, 3, 5 and 10 years respectively. Pneumatic dilation is safer than commonly thought and efficacious, although multiple dilations will be needed over a lifetime in most patients. Standardisation of the technique should be attempted.
Methods- Literature search for all studies, in which pneumatic dilation was performed for treatment of achalasia, was conducted. Studies, in which clear endpoints of efficacy of single dilation sessions over a period of years, were chosen.
- Response for a single dilation session was 66% at 1 year and 59, 53, 50 and 25% at 2, 3, 5 and 10 years respectively.
- Use of a Rigiflex dilator and multiple dilations during the initial treatment improved efficacy.
- Overall perforation rate was only 2% (24/1358) of which only 1% required surgery.
- Use of multiple dilations led to increased perforation risk.
- Method of dilation used with regard to balloon size, pressure used, dilation times and single or multiple dilations varied in almost every study.
