LONG TERM RESULTS OF SINGLE SESSION OF PNEUMATIC BALLOON DIALATATION FOR ACHALASIA CARDIA

BACKGROUND: Achalasia is a disorder of the esophagus characterized by increased lower esophageal sphincter (LES) tone, lack of LES relaxation with swallowing and aperistalsis of the body of the esophagus. Current therapy is aimed at reducing the pressure gradient across the LES to allow passage of food. Therapeutic options are pharmacologic therapy, surgical myotomy, endoscopic balloon dilation, metal or plastic self expandable stent placement and injection of botulinum toxin.AIM: To prospectively evaluate whole series of our patients for efficacy, durability and safety of single session of pneumatic dilatation of AchalasiaMETHODS: Patients were diagnosed on basis of clinical assessment, barium study and endoscopy. Patients with eckradt score more than three underwent single session of pneumatic dilatation with 30 mm Achalasia balloon (Boston Scientific Corporation, Boston, MA, USA). Patients were followed up yearly. Eckradt score less than 4 was considered remission while more than 3 considered recurrence.RESULTS: Total 31 patients with mean age 38 years underwent pneumatic dilatation. 25 (80.6%) patients achieved stable clinical remission(SCR) over mean follow up of 27 months. 4 patients out of the non responders achieved SCR with second session of pneumatic dilatation with larger balloon. None of the patients had periprocedure complication except chest pain. Late complications Ie GERD and Esophagitis were present in 12(38%) of patients.CONCLUSION: pneumatic balloon dilatation is safe and effective treatment of Achalasia.