Hydraulic dilation with a shape-measuring balloon in idiopathic achalasia: a feasibility study

Wouter F. W. Kappelle; Auke Bogte; Peter D. Siersema

doi:10.1055/s-0034-1392481

Endoscopy, Table of Contents

Endoscopy 2015; 47(11): 1028-1034
DOI: 10.1055/s-0034-1392481

Innovations and brief communications

Hydraulic dilation with a shape-measuring balloon in idiopathic achalasia: a feasibility study

Wouter F. W. Kappelle

Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands

,

Auke Bogte

Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands

,

Peter D. Siersema

Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands

› Author Affiliations

Abstract

Background and aim: Pneumatic dilation is a commonly used treatment in achalasia. Recent studies have shown that esophageal distensibility measurements can be used to assess the effect of dilation and possibly the risk of perforation. A new hydraulic dilation balloon allows visualization of the shape of the balloon in vivo and measurement of distensibility during dilation. We aimed to evaluate the technical feasibility of a 30-mm shape-measuring hydraulic dilation balloon for the treatment of achalasia.

Methods: Consecutive patients with newly diagnosed achalasia were dilated using a 30-mm shape-measuring hydraulic dilation balloon. Patients were contacted 1 week, 1 month, and 3 months after dilation. Technical success, clinical success, and major complications were evaluated.

Results: Technical success was achieved in all of the 10 patients included. Median esophagogastric junction distensibility (mm²/mmHg) increased from 1.1 (IQR 0.6 – 1.3) before dilation therapy to 7.0 (IQR 5.5 – 17.8) afterwards (P = 0.005). No major complications were seen. Three patients (30 %) reported recurrent dysphagia.

Conclusion: Hydraulic dilation with a shape-measuring balloon in achalasia patients is feasible. In vivo esophageal distensibility measurements may allow for an individualized, patient-specific dilation regimen.

The Netherlands National Trial Register: NTR4371

Full Text

References

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