Chuah SK, Wu KL, Hu TH, Tai WC, Changchien CS. Endoscope-guided pneumatic dilation for treatment of esophageal achalasia. World J Gastroenterol 2010; 16(4): 411-417 [PMID: 20101764 DOI: 10.3748/wjg.v16.i4.411]
Corresponding Author of This Article
Chi-Sin Changchien, MD, Gastrointestinal Motility Unit, Division of Hepatogastroenterology, Chang Gang Memorial Hospital, Kaohsiung Medical Center, No. 123, Ta-Pei Road, Niaosung Hsiang, Kaohsiung 833, Taiwan, China. chuahsk@seed.net.tw
Article-Type of This Article
Editorial
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World J Gastroenterol. Jan 28, 2010; 16(4): 411-417 Published online Jan 28, 2010. doi: 10.3748/wjg.v16.i4.411
Endoscope-guided pneumatic dilation for treatment of esophageal achalasia
Seng-Kee Chuah, Keng-Liang Wu, Tsung-Hui Hu, Wei-Chen Tai, Chi-Sin Changchien
Seng-Kee Chuah, Keng-Liang Wu, Tsung-Hui Hu, Wei-Chen Tai, Chi-Sin Changchien, Gastrointestinal Motility Unit, Division of Hepatogastroenterology, Chang Gang Memorial Hospital, Kaohsiung Medical Center, No. 123, Ta-Pei Road, Niaosung Hsiang, Kaohsiung 833, Taiwan, China; Chang Gung University College of Medicine, No. 123, Ta-Pei Road, Niaosung Hsiang, Kaohsiung 833, Taiwan, China
Author contributions: Chuah SK and Changchien CS drafted the editorial; all other authors wrote the final version.
Correspondence to: Chi-Sin Changchien, MD, Gastrointestinal Motility Unit, Division of Hepatogastroenterology, Chang Gang Memorial Hospital, Kaohsiung Medical Center, No. 123, Ta-Pei Road, Niaosung Hsiang, Kaohsiung 833, Taiwan, China. chuahsk@seed.net.tw
Received: October 19, 2009 Revised: December 14, 2009 Accepted: December 21, 2009 Published online: January 28, 2010
Abstract
Pneumatic dilation (PD) is considered to be the first line nonsurgical therapy for achalasia. The principle of the procedure is to weaken the lower esophageal sphincter by tearing its muscle fibers by generating radial force. The endoscope-guided procedure is done without fluoroscopic control. Clinicians usually use a low-compliance balloon such as Rigiflex dilator to perform endoscope-guided PD for the treatment of esophageal achalasia. It has the advantage of determining mucosal injury during the dilation process, so that a repeat endoscopy is not needed to assess the mucosal tearing. Previous studies have shown that endoscope-guided PD is an efficient and safe nonsurgical therapy with results that compare well with other treatment modalities. Although the results may be promising, long-term follow-up is required in the near future.
