Clinical study on intrasphincteric injection of botulinum toxin and/ or small balloon dilation in patients with esophageal achalasia / 中华消化内镜杂志

ABSTRACT

Objective To compare the effectiveness and adverse effects among three groups of patients with esophageal achalasia treated with small balloon dilation and/or intrasphincteric injection of botulinum toxin. Methods Forty-eight patients were divided randomly into three groups, A, B, and C, treated with small balloon dilation, intrasphincteric injection of botulinum toxin, and combination of these two respectively. At 1 week, 3 months and 1 year after treatment, the clinical scores, lower oesophageal sphincter-ic pressure, and lower oesophageal sphincteric relax rate in three groups were compared. Results At 1 week, 3 months and 1 year after treatment, the effective rates and gaps of pre - and post - treatment LESP and LESRR were higher in group B and C than those in group A. There were no differences between BT group and combination group at 1 week and 3 months, but in 1 year after treatment the effective rates and gaps of LESP and LESRR in combination group were higher than those in BT group. Complications never happened in all groups. Conclusion The combination of small balloon dilation and intrasphincteric injection of botulinum toxin was the effective procedure with the advantages of lasting longer time, less complications and milder chest pain.