Efficacy of rigiflex balloon dilatation in 12 children with achalasia: a 6-month prospective study showing weight gain and symptomatic improvement

Abstract

Achalasia cardia is a disease of adolescents and is rare in children. In total, 12 children with primary achalasia, with a mean age of 10.8 +/- 2 years, were prospectively evaluated for the efficacy of a 30-mm-diameter Rigiflex balloon for relief of symptoms and weight gain after 1 and 6 months of follow up. The 12 children were evaluated and treated for achalasia, with pneumatic balloon dilatation, from January 1998 to December 2000. They were studied for basal, 1-, and 6-month post-dilatation composite symptoms for dysphagia, regurgitation, night cough and heartburn. Basal and 5-min post-dilatation barium swallow were obtained to compare barium height and width for efficacy of dilatation and to evaluate for complications. There were no complications. Barium height, width, composite symptom score and weight improved significantly up to the 6-month follow up. Rigiflex balloon dilatation of 30-mm diameter is safe and effective in children with achalasia.

Pneumatic balloon dilation in pediatric achalasia: efficacy and factors predicting outcome at a single tertiary pediatric gastroenterology center

“…9,[31][32][33][34] Although there are reported perforation rates of 4% to 12% in adult patients, [10][11][12][13][14][15][16][17][18][19][20][21][22] no perforations have been documented in pediatric patients. [23][24][25][26][27][28][29][30] In our series, we did not observe serious complications, only self-limited postprocedural pain in 11% of patients.…”

“…A review of the literature shows that PD is successful in the majority of reported pediatric series, with success rates of 45% to 90%; this method has not gained universal acceptance in children. [23][24][25][26][27][28][29][30] Azizkhan et al 25 and Nakayama et al 26 reported that PD was unsuccessful in children younger than 9 years of age and technically difficult to perform in children younger than 5 years of age. This is the largest prospective study in pediatric achalasia aimed at evaluating the efficacy and safety of PD as well as factors predicting outcome.…”

“…[11][12][13][14][15][16][17][18][19][20][21][22] All of these studies were performed in adults, and often retrospectively. Experience with pediatric patients is limited to small retrospective series, [23][24][25][26][27][28][29][30] and possible predictive response factors have never been studied in the pediatric age group.…”

Equipment for pediatric endoscopy

“…96,97 Pneumatic dilation for achalasia has been compared with surgical myotomy in several small reviews. [82][83][84][85][86][87][88] Most conclude that surgery offers a more durable benefit, but pneumatic dilation is effective and is a reasonable first-line therapy in children. Argon plasma coagulation using a 2.3-or 1.5-mm probe was used in a series of 13 pediatric patients, mainly for bleeding (n ϭ 12) indications (eg, ulcers, hemangioma, eroding tumor mass).…”

“…[82][83][84][85][86][87][88] Pediatric-specific pneumatic dilation balloons are not produced, and standard 30-, 35-, and 40-mm polyurethane balloons are used.…”