Combined treatment of achalasia - botulinum toxin injection followed by pneumatic dilatation: long-term results

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Authors

KROUPA Radek HEP Aleš DOLINA Jiří VÁLEK Vlastimil MATYÁŠOVÁ Zuzana PROKEŠOVÁ Jitka SEDMÍK Jaroslav NOVOTNÝ Ivo

Year of publication 2010
Type Article in Periodical
Magazine / Source Diseases of the Esophagus
MU Faculty or unit

Faculty of Medicine

Citation
Field Surgery incl. transplantology
Keywords achalasia - botulinum toxin- pneumatic dilatatation- therapy
Description Injection of botulinum toxin (BT) and pneumatic dilatation are available methods in nonsurgical treatment of achalasia. Authors anticipate beneficial effect of prior BT injection on the success of pneumatic dilatation and duration of its effect. There are no long-term data available to assess efficacy of combined treatment.Result of prospective study on 51 consecutive patients treated by comination method are presented. The cumulative 5 years remission rate in combined treated patients 69% was higher than in controls 50%; however it, was not statistically significant (P = 0.07). Eight patients (17%) with relapse of dysphagia were referred to laparoscopic Heller myotomy with no surgical complication.Initial injection of BT followed by PD seems to be effective for long-term results with fewer complications. But the combined therapy is not significantly superior to PD alone.
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