Factors determining successful outcome following pneumatic balloon dilation in achalasia cardia.

ABSTRACT

BACKGROUND: Pneumatic balloon dilation is a popular method of treating patients with achalasia cardia. It may be useful to know the factors that predict response to this treatment. AIM: To determine predictors of outcome following pneumatic balloon dilation in patients with achalasia cardia. METHODS: Records of 62 patients who had undergone pneumatic dilation using Rigiflex balloon dilators (Boston Scientific, Boston, MA, USA) were reviewed. Follow-up data were available for 52 patients. Data from patients with and without improvement in symptoms were compared. RESULTS: Of the 52 patients (age mean 44 [range 11-68] years; 27 male; median symptom duration 20 [4-90] months], 42 (81%) patients had response in symptoms after balloon dilatation. On univariate analysis, the responders more often had age> 40 years (26/42 [62%] versus 1/10 [10%], p=0.003), and less often had lower esophageal sphincter pressure> 50 mmHg (8/10 [80%] versus 10/42 [24%], p=0.0007) and mid-esophageal body hypocontraction (7/10 [70%] versus 12/24 [29%] p=0.01) than the non-responders. On multivariate analysis only age <or= 40 years (p=0.02) was associated with poor outcome. CONCLUSION: Younger age may predict non-response to balloon dilation using Rigiflex balloon dilators in patients with achalasia cardia.