Russo A, Virgilio C, Aprile G, Cosentino S, Favara C, Russo V
Dipartimento di Chirurgia, Università degli Studi di Catania.
Ann Ital Chir. 1993 Nov-Dec;64(6):701-6; discussion 707.
We report immediate and late clinical results achieved in 33 patients with achalasia treated with pneumatic dilation as an outpatient procedure. Thirty patients were seen before any therapy and 3 following a failed esophagomyotomy. All patients were submitted to clinical, radiological and manometric evaluation before treatment: six of them belonged to Adams' class I, 19 to class II and 8 to class III. The dilations were performed with Microvasive Regiflex System (30-35-40. mm.). The average number of dilations per patient was 1.4; one dilation was performed in 25 patients, 2 dilations in 6, and three dilation in two. The patients after the dilation were controlled for a maximum period of 3 hours before being discharged from the outpatient facilities. No complications, worthy of note, was related to the procedures. The clinical results were subdivided in four classes according to Vantrappen's schema. Ten days--immediate results--after the first dilation excellent-good results were obtained in 26 patients (78.8%); moderate results in four (12.1%) and poor results in three (9.1%). The mean LES pressure, evaluated in 15 out of 25 cases fell from 37.6 mmHg. Before treatment to a value of 16.2 mmHg after treatment (p < 0.005). Of the 30 patients followed for an average period of 30.6 months (2-82)--late results--excellent-good results were obtained in 24 (80%), moderate results in 4 (13.3%) and poor in 2 (6.7%). In conclusion the clinical results, of our study, repeat those published in a previous prospective evaluation.(ABSTRACT TRUNCATED AT 250 WORDS)
我们报告了33例贲门失弛缓症患者接受门诊气钡双重造影治疗后的近期和远期临床结果。30例患者在接受任何治疗前就诊,3例在食管肌层切开术失败后就诊。所有患者在治疗前均接受了临床、放射学和测压评估:其中6例属于亚当斯I级,19例属于II级,8例属于III级。使用Microvasive Regiflex系统(30 - 35 - 40毫米)进行扩张。每位患者的平均扩张次数为1.4次;25例患者进行了1次扩张,6例进行了2次扩张,2例进行了3次扩张。扩张后的患者在门诊设施出院前最多观察3小时。未发现与手术相关的值得注意的并发症。根据万特拉彭的模式,临床结果分为四类。首次扩张后10天(近期结果),26例患者(78.8%)获得了优 - 良好的结果;4例(12.1%)为中等结果,3例(9.1%)为差的结果。25例中有15例评估的平均LES压力从治疗前的37.6 mmHg降至治疗后的16.2 mmHg(p < 0.005)。在平均随访30.6个月(2 - 82个月)的30例患者中(远期结果),24例(80%)获得了优 - 良好的结果,4例(13.3%)为中等结果,2例(6.7%)为差的结果。总之,我们研究的临床结果与先前前瞻性评估中发表的结果一致。(摘要截断于250字)