Endoscopy 2018; 50(04): S135-S136
DOI: 10.1055/s-0038-1637435
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

EVALUATION OF THE ENDOSCOPIC TREATMENT OF ACHALASIA

S Elaboudi
1   Mohamed V- Souissi, Gastro-enterology ‘Medecine C’, Rabat, Morocco
,
I Benelbarhdadi
1   Mohamed V- Souissi, Gastro-enterology ‘Medecine C’, Rabat, Morocco
,
FZ Ajana
1   Mohamed V- Souissi, Gastro-enterology ‘Medecine C’, Rabat, Morocco
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Pneumatic dilation (PD) is considered the first line therapy for achalasia. The aim of our study is to demonstrate the efficiency of this treatment and to evaluate the predictive factors of its success and those of symptom recurrence.

Methods:

It's a retrospective, descriptive and analytic study. All patients received PD using a Rigiflex balloon of 35 mm diameter, with 3 consecutive inflations of 1 minute each, with an average inflation pressure of 7 psi. The statistical analysis is carried out by the SPSS software version 15.0.

Results:

A total of 86 patients were included, 37 male and 49 female. Mean age was 45 years. All patients had dysphagia, which was paradoxical in 42% of cases. The diagnosis was made by upper gastrointestinal series test and gastroscopy which both demonstrated a megaesophagus in 85% of cases. This diagnosis was confirmed by the esophageal manometry performed in 49% of the patients, which demonstrated aperistalsis in all cases, associated with hypertonic lower esophageal sphincter only in 56% of cases. Dysphagia had immediately improved in 97% of patients, after one PD. Medical treatment (Nifedipine) was associated to PD in 33 patients. The mean follow-up duration was 3 years. During this follow up, PD was effective in 63 patients. 17 patients (21%) had recurrence of dysphagia, with a mean recurrence interval of 19 months. Only 1 patient underwent surgery because he has failed to respond to PD. 1 case of esophageal perforation has occurred. The statistical study analyzed the predictive factors of PD success and symptom recurrence, which are: Age, sex and medical treatment. There was no significant difference in the recurrence of dysphagia between patients who took medical treatment and those who did not (p = 0.249). we also studied the impact of these factors on dysphagia recurrence. The univariate logistic regression analysis showed that there is no relationship between dysphagia recurrence and independent predictive factors.

Conclusions:

Pneumatic dilation is the first line therapy for achalasia which immediately improve dysphagia.