Comparison of Pneumatic Dilation with Pneumatic Dilation Plus Botulinum Toxin for Treatment of Achalasia
Among the therapeutic options for achalasia are pneumatic dilatation (PD), an appropriate long-term therapy, and botulinum toxin injection (BT) that is a relatively short-term therapy. This study aimed to compare therapeutic effect of repetitive pneumatic dilation with a combined method (botulinum t...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Tehran University of Medical Sciences
2010-03-01
|
| Series: | Acta Medica Iranica |
| Subjects: | |
| Online Access: | http://journals.tums.ac.ir/PdfMed.aspx?pdf_med=/upload_files/pdf/15255.pdf&manuscript_id=15255 |
| _version_ | 1818908027103739904 |
|---|---|
| author | Alireza Bakhshipour Romina Rabbani Shapoor Shirani Hosein ASL Soleimani Javad Mikaeli |
| author_facet | Alireza Bakhshipour Romina Rabbani Shapoor Shirani Hosein ASL Soleimani Javad Mikaeli |
| author_sort | Alireza Bakhshipour |
| collection | DOAJ |
| description | Among the therapeutic options for achalasia are pneumatic dilatation (PD), an appropriate long-term therapy, and botulinum toxin injection (BT) that is a relatively short-term therapy. This study aimed to compare therapeutic effect of repetitive pneumatic dilation with a combined method (botulinum toxin injection and pneumatic dilation) in a group of achalasia patients who are low responder to two initial pneumatic dilations. Thirty- four patients with documented primary achalasia that had low response to two times PD (<50% decrease in symptom score and barium height at 5 minute in timed esophagogram after 3month of late PD) were randomized to receive pneumatic dilation (n=18) or botulinum toxin injection and pneumatic dilation by four weeks interval (n=16), PD and BT+PD groups respectively. Symptom scores were evaluated before and at 1, 6 and 12 months after treatment. Clinical remission was defined as a decrease in symptom score ≥ 50% of baseline. There were no significant differences between the two groups in gender, age and achalasia type. Remission rate of patients in BT-PD group in comparison with PD group were 87.5% vs. 67.1% (P = 0.7), 87.5% vs. 61.1% (P = 0.59) and 87.5% vs. 55.5% (P = 0.53) at 1, 6 and 12 months respectively .There were no major complications in either group. The mean symptom score decreased by 62.71% in the BT-PD group (P < 0.002) and 50.77% in the PD group (P < 0.01) at the end of the first year. Despite a better response rate in BT+PD group, a difference was not statistically significant. A difference may be meaningful if a large numbers of patients are included in the study. |
| first_indexed | 2024-12-19T22:04:29Z |
| format | Article |
| id | doaj.art-35a5222fa881487e9d5ad05027c6ef1b |
| institution | Directory Open Access Journal |
| issn | 0044-6025 |
| language | English |
| last_indexed | 2024-12-19T22:04:29Z |
| publishDate | 2010-03-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Acta Medica Iranica |
| spelling | doaj.art-35a5222fa881487e9d5ad05027c6ef1b2022-12-21T20:04:04ZengTehran University of Medical SciencesActa Medica Iranica0044-60252010-03-01482107110Comparison of Pneumatic Dilation with Pneumatic Dilation Plus Botulinum Toxin for Treatment of AchalasiaAlireza BakhshipourRomina RabbaniShapoor ShiraniHosein ASL SoleimaniJavad MikaeliAmong the therapeutic options for achalasia are pneumatic dilatation (PD), an appropriate long-term therapy, and botulinum toxin injection (BT) that is a relatively short-term therapy. This study aimed to compare therapeutic effect of repetitive pneumatic dilation with a combined method (botulinum toxin injection and pneumatic dilation) in a group of achalasia patients who are low responder to two initial pneumatic dilations. Thirty- four patients with documented primary achalasia that had low response to two times PD (<50% decrease in symptom score and barium height at 5 minute in timed esophagogram after 3month of late PD) were randomized to receive pneumatic dilation (n=18) or botulinum toxin injection and pneumatic dilation by four weeks interval (n=16), PD and BT+PD groups respectively. Symptom scores were evaluated before and at 1, 6 and 12 months after treatment. Clinical remission was defined as a decrease in symptom score ≥ 50% of baseline. There were no significant differences between the two groups in gender, age and achalasia type. Remission rate of patients in BT-PD group in comparison with PD group were 87.5% vs. 67.1% (P = 0.7), 87.5% vs. 61.1% (P = 0.59) and 87.5% vs. 55.5% (P = 0.53) at 1, 6 and 12 months respectively .There were no major complications in either group. The mean symptom score decreased by 62.71% in the BT-PD group (P < 0.002) and 50.77% in the PD group (P < 0.01) at the end of the first year. Despite a better response rate in BT+PD group, a difference was not statistically significant. A difference may be meaningful if a large numbers of patients are included in the study.http://journals.tums.ac.ir/PdfMed.aspx?pdf_med=/upload_files/pdf/15255.pdf&manuscript_id=15255Balloon dilationbotulinum toxinsesophageal achalasia |
| spellingShingle | Alireza Bakhshipour Romina Rabbani Shapoor Shirani Hosein ASL Soleimani Javad Mikaeli Comparison of Pneumatic Dilation with Pneumatic Dilation Plus Botulinum Toxin for Treatment of Achalasia Acta Medica Iranica Balloon dilation botulinum toxins esophageal achalasia |
| title | Comparison of Pneumatic Dilation with Pneumatic Dilation Plus Botulinum Toxin for Treatment of Achalasia |
| title_full | Comparison of Pneumatic Dilation with Pneumatic Dilation Plus Botulinum Toxin for Treatment of Achalasia |
| title_fullStr | Comparison of Pneumatic Dilation with Pneumatic Dilation Plus Botulinum Toxin for Treatment of Achalasia |
| title_full_unstemmed | Comparison of Pneumatic Dilation with Pneumatic Dilation Plus Botulinum Toxin for Treatment of Achalasia |
| title_short | Comparison of Pneumatic Dilation with Pneumatic Dilation Plus Botulinum Toxin for Treatment of Achalasia |
| title_sort | comparison of pneumatic dilation with pneumatic dilation plus botulinum toxin for treatment of achalasia |
| topic | Balloon dilation botulinum toxins esophageal achalasia |
| url | http://journals.tums.ac.ir/PdfMed.aspx?pdf_med=/upload_files/pdf/15255.pdf&manuscript_id=15255 |
| work_keys_str_mv | AT alirezabakhshipour comparisonofpneumaticdilationwithpneumaticdilationplusbotulinumtoxinfortreatmentofachalasia AT rominarabbani comparisonofpneumaticdilationwithpneumaticdilationplusbotulinumtoxinfortreatmentofachalasia AT shapoorshirani comparisonofpneumaticdilationwithpneumaticdilationplusbotulinumtoxinfortreatmentofachalasia AT hoseinaslsoleimani comparisonofpneumaticdilationwithpneumaticdilationplusbotulinumtoxinfortreatmentofachalasia AT javadmikaeli comparisonofpneumaticdilationwithpneumaticdilationplusbotulinumtoxinfortreatmentofachalasia |