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首页> 外文期刊>World Journal of Gastroenterology >Long-term results of pneumatic dilation for achalasia: A 15 years' experience.
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Long-term results of pneumatic dilation for achalasia: A 15 years' experience.

机译：气管扩张治疗门失弛缓症的长期效果：15年的经验。

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AIM: Although most patients with achalasia respond to pneumatic dilation, one-third experienced recurrence, and prolonged follow-up studies on parameters associated with various outcomes are scanty. In this retrospective study, we reported a 15-years' experience with pneumatic dilation treatment in patients with primary achalasia, and determined whether previously described predictors of outcome remain significant after endoscopic dilation. METHODS: Between September 1989 and September 2004, 39 consecutive patients with primary symptomatic achalasia (diagnosed by clinical presentation, esophagoscopy, barium esophagogram, and manometry) who received balloon dilation were followed up at regular intervals in person or by phone interview. Remission was assessed by a structured interview and a previous symptoms score. The median dysphagia-free duration was calculated by Kaplan-Meier analysis. RESULTS: Symptoms were dysphagia (n = 39, 100%), regurgitation (n = 23, 58.7%), chest pain (n = 4, 10.2%), and weight loss (n = 26, 66.6%). A total of 74 dilations were performed in 39 patients; 13 patients (28%) underwent a single dilation, 17 patients (48.7%) required a second procedure within a median of 26.7 mo (range 5-97 mo), and 9 patients (23.3%) underwent a third procedure within a median of 47.8 mo (range 37-120 mo). Post-dilation lower esophageal sphincter (LES) pressure, assessed in 35 patients, has decreased from a baseline of 35.8+/-10.4-10.0+/-7.1 mmHg after the procedure. The median follow-up period was 9.3 years (range 0.5-15 years). The dysphagia-free duration by Kaplan-Meier analysis was 78%, 61% and 58.3% after 5, 10 and 15 years respectively. CONCLUSION: Balloon dilation is a safe and effective treatment for primary achalasia. Post-dilation LES pressure estimation may be useful in assessing response.
机译：目的：尽管大多数门失弛缓症患者对充气扩张有反应，但三分之一的患者复发，并且长期随访研究与各种预后相关的参数很少。在这项回顾性研究中，我们报道了在原发性门失弛缓症患者中进行气动扩张治疗的15年经验，并确定了先前描述的预后指标在内镜下扩张后是否仍然显着。方法：自1989年9月至2004年9月，对39例原发性症状性门失弛缓症患者（通过临床表现，食管镜检查，钡剂食管造影和压力测定法诊断）连续接受了球囊扩张的随访，应亲自或通过电话随访。通过结构化访谈和先前症状评分评估缓解情况。通过Kaplan-Meier分析计算中位无吞咽困难持续时间。结果：症状为吞咽困难（n = 39，100％），反流（n = 23，58.7％），胸痛（n = 4、10.2％）和体重减轻（n = 26，66.6％）。 39例患者共进行了74次扩张； 13位患者（28％）进行了一次单次扩张，17位患者（48.7％）需要在26.7个月（5-97个月）范围内进行第二次手术，而9位患者（23.3％）在需要进行中度扩张的情况下进行第三次手术47.8 mo（范围37-120 mo）。在35例患者中评估的扩张后食管下括约肌（LES）压力已从手术后的基线35.8 +/- 10.4-10.0 +/- 7.1 mmHg降低。中位随访期为9。3年（范围0。5-15年）。通过Kaplan-Meier分析得出的无吞咽困难持续时间分别为5年，10年和15年后分别为78％，61％和58.3％。结论：球囊扩张术是治疗原发性门失弛缓症的安全有效方法。扩张后LES压力估计可能对评估反应有用。

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