Efficacy and Safety of Endoscopic-guided Balloon Dilatation without Fluoroscopy for the Treatment of Achalasia
Kanokwan Pinyopornpanish MD1, Chamard Wongsa MD1, Nithi Thinrungroj MD1, Apinya Leerapun MD1, Pises Pisespongsa MD2, Taned Chitapanarux MD1, Satawat Thongsawat MD1, Phuripong Kijdamrongthum MD1
Affiliation : 1 Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand 2 Bumrungrad Hospital, Bangkok, Thailand
Background : Achalasia is a primary esophageal motor disorder of unknown etiology. One of the standard treatments is
pneumatic balloon dilatation under fluoroscopic guidance. Endoscopic-guided balloon dilatation without fluoroscopy can
also be performed, but the efficacy and associated safety issues remain unclear.
Objective : To assess efficacy and safety of endoscopic-guided balloon dilatation technique for achalasia treatment at Maharaj
Nakorn Chiang Mai Hospital.
Materials and Methods : This study is a retrospective, descriptive study in achalasia patients who were initially diagnosed
and treated with the endoscopic-guided balloon dilatation technique between January 2007 and December 2012. Achalasia
symptoms before and after treatment were evaluated to assess the efficacy. Immediate complications and long term follow-
up were used to assess safety of this method.
Results : Sixteen eligible achalasia patients who underwent the dilatation under endoscopic guidance were included in the
analysis. There was a significant improvement in Eckardt score from 6.6+1.9 to 0.5+0.7 (p-value <0.001). All patients
(100%) had improvement in dysphagia symptoms and gained weight after the dilatation procedure. No serious complications
were observed.
Conclusion : Endoscopic guided pneumatic balloon dilatation as an initial treatment of achalasia is a safe technique and has
a high level of efficacy.
Keywords : Achalasia, Endoscopy, Fluoroscopy, Pneumatic balloon dilatation
