Ten-year experience of pneumatic balloon dilatation of esophago-gastric junction

Keywords: graded pneumatic balloon dilatation; achalasia; stenosis of esophago-gastric junction.

Abstract

Objective. To choose an optimal regime of pneumatic balloon dilatation (PBD) of esophago-gastric junction under roentgenological control in achalasia and stenosis after hiatoplasty and fundoplication.

Маterials and methods. In 2007 - 2017 yrs PBD was accomplished in 34 patients with achalasia Stages I-II; 13 – with recurrence after laparoscopic cardiomyotomy (LCМ); 14 – with functional dysphagia or achalasia after hiatoplasty and fundoplication.

Results. Morbidity after PBD was absent. In all patients a remission was achieved through various terms and have depended upon dysphagia cause. The recurrences occurred were analyzed and compared with results of reoperations.

Conclusion. PBD is highly effective and is not accompanied by complications while follow-up of the procedure strictly. Оptimal regime of PBD assumes a graded raising of pressure from 20 tо 26.7 kPa (from 150 tо 200 mm Hg), exposition from 30 tо 60 s, which are compared with degree of the balloon blow grade and the patient’s reaction on the pain occurred. PBD helps to establish the level and cause of stenosis in achalasia recurrence after LCM and after hiatal plasty and fundoplication, and, thus, - to determine indications for reoperation and its volume.

Author Biographies

A. V. Malynovskyi, Оdessa National Medical University

Andrii V. Malynovskyi, PhD.,         
Chair of Department of Robotic and Endoscopic Surgery,
Odessa National Medical University.
Address: 4 Ol'hiivs'ka Str., 65000, Odessa, Ukraina,
tel: +380663269040
E-mail: endosurgery2017@gmail.com
http://orcid.org/0000-0002-8549-5019

М. N. Majorenko, Оdessa National Medical University

Marina N. Majorenko,
Assistant of Deparment of Robotic and Endoscopic Surgery,
Odessa National Medical University.
Adress: 4 Ol'hiivs'ka Str., 65000, Odessa, Ukraina,
tel: +380639764398
E-mail: endosurgery2017@gmail.com
http://orcid.org/0000-0002-7918-9445

N. N. Chernov, Оdessa National Medical University

Nikolaj N. Chernov,
Assistant of Deparment of Robotic and Endoscopic Surgery,
Odessa National Medical University.
Adress: 4 Ol'hiivs'ka Str., 65000, Odessa, Ukraina,
tel: +380662065737
E-mail: endosurgery2017@gmail.com
http://orcid.org/0000-0003-0187-8299

M. J. Shigimaga, Оdessa National Medical University

Maksym J. Shigimaga
Resident of Deparment of Robotic and Endoscopic Surgery,
Odessa National Medical University.
Adress: 4 Ol'hiivs'ka Str., 65000, Odessa, Ukraina,
tel: +380508745288
E-mail: endosurgery2017@gmail.com
http://orcid.org/0000-0002-8549-5019

D. V. Kudinov, Оdessa National Medical University

Denis V. Kudinov,
Resident of Deparment of Robotic and Endoscopic Surgery,
Odessa National Medical University.
Adress: 4 Ol'hiivs'ka Str., 65000, Odessa, Ukraina,
tel: +380999241495
E-mail: endosurgery2017@gmail.com
http://orcid.org/0000-0001-7651-0988

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Published
2018-06-26
Section
General Problems of Surgery