Department of Gastroenterology, Ankara City Hospital, Ankara, Turkey.
Department of Nutrition and Dietetics, Hacettepe University Faculty of Health Sciences, Ankara, Turkey.
Turk J Gastroenterol. 2023 Apr;34(4):332-338. doi: 10.5152/tjg.2023.22178.
The aim of the study was to share the effectiveness of pneumatic dilation in geriatric achalasia patients.
Achalasia patients over the age of 65 and those under the age of 65 as the control group who received pneumatic dilation as the first-line treatment were evaluated in the study.
The average age of geriatric patients was 72.5 ± 55.92 years (65-90), with 50.3% of them being male. Follow-up was conducted for a mean of 64.52 ± 38.73 months. While pneumatic dilation was successful in 98.6% (141/143) of geriatric patients, it was also successful in 94% (141/150) of non-geriatric patients. Remission after single balloon dilatation was observed in 81.8% of geriatric patients, while it was observed in only 52.7% of non-geriatric patients (P = .000). When comparing remission after single dilatation and multiple dilatations, it was observed that geriatric patients who achieved remission after multiple balloon dilatation had higher lower esophageal sphincter pressure and Eckardt scores at the diagnosis and higher lower esophageal sphincter pressure and esophageal body resting pressures after the first balloon dilatation.
The proportion of elders in the world population is increasing daily and this disease has been known to disproportionately afflict this group. Although surgical treatments, in particular per-oral endoscopic myotomy, have recently gained popularity as therapies for achalasia, pneumatic dilation remains the most commonly used in geriatric patients.
本研究旨在分享气囊扩张术治疗老年贲门失弛缓症患者的疗效。
本研究评估了 65 岁以上（老年组）和 65 岁以下（对照组）接受气囊扩张术作为一线治疗的贲门失弛缓症患者。
老年患者的平均年龄为 72.5 ± 55.92 岁（65-90 岁），其中 50.3%为男性。平均随访 64.52 ± 38.73 个月。虽然气囊扩张术在 98.6%（141/143）的老年患者中获得成功，在 94%（141/150）的非老年患者中也获得成功。单次球囊扩张后缓解率在老年患者中为 81.8%，而非老年患者中仅为 52.7%（P =.000）。比较单次和多次扩张后的缓解率，发现多次气囊扩张后缓解的老年患者在诊断时食管下括约肌压力和 Eckardt 评分较高，首次球囊扩张后食管下括约肌压力和食管体静息压力较高。
全球人口中老年人的比例日益增加，这种疾病在这一人群中发病率更高。虽然手术治疗，特别是经口内镜肌切开术，最近已成为贲门失弛缓症的治疗方法，但气囊扩张术仍然是老年患者最常用的治疗方法。
