Comparison of endoscopic balloon dilation with surgical therapy in management of esophageal achalasia
10.3760/cma.j.issn.0254-1432.2009.01.003
- VernacularTitle:贲门失弛缓症的内镜治疗与外科手术处理方法比较
- Author:
Xiaoqing ZENG
;
Shiyao CHEN
;
Jian WANG
;
Lili MA
;
Yanjun NI
;
Qun WANG
;
Liqing YAO
- Publication Type:Journal Article
- Keywords:
Esophageal achalasia;
Cardia;
Endoscopig,digestive system;
Surgical procedures,operative
- From:
Chinese Journal of Digestion
2009;29(1):8-12
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effects and safety of endoscopic balloon dilation with surgical therapy in treating esophageal achalasia. Methods The patients who were diagnosed as achalasia of cardia from Jan. 2002 to Dec. 2007 were consecutively collected. All patients were divided into endoscopic balloon dilation group (endoscopy group), thorascopic / laparoseopic surgery group (telescopy group) and standard thoracotomy group (operation group). The efficacy, relapse rate and safety were compared among three groups. Results Ninety eight patients were enrolled. There were 57 patients in endoscopy group, 24 patients in telescopy group, and 17 patients in opreation group. All of the patients completed the treatment. There was one case (1.6%) in endoscopy group complicated with esophageal rupture, two (8.3%) in telescopy group complicated with esophageal fistula, and one (5.9%) in operation group complicated with severe post-operation pneumonia infection, acute respiratory distress syndrome and infectious shock. The rest patients had symptomatic relief of dysphagia in different degrees after therapy, and that was further confirmed by symptoms assessment, x-ray, or endoscopic examination after one month. Five patients (8.9%) in endoscopy group relapsed, with a duration of 5 to 31 months (mean 8 months), and underwent re-dilation or stent placement successfully. One patient (4.2%) in telescopy group relapsed after 6 months and underwent re-dilation successfully. No one relapsed in operation group. Conclusions Compared with standard operation group and telescopy group, endoscopic balloon dilation is deserved to use widely in clinical application with its advantages of simple, convenient and low complication. In spite of its relapse, it still can be remedied well by endoscopic re-dilation or stent placement.
