SynthesisNeurogastroenterology and motility2019
Efficacy and safety of pneumatic dilation in achalasia: A systematic review and meta-analysis.
Synthesis in Neurogastroenterology and motility, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Phosphodiesterase 5 (PDE-5) inhibitors (sildenafil, tadalafil, and vardenafil) effects on esophageal motility: a systematic review.BMC gastroenterology · 2023Pooled it
- European guidelines on achalasia: United European Gastroenterology and European Society of Neurogastroenterology and Motility recommendations.United European gastroenterology journal · 2020Guideline
- Efficacy and safety of pneumatic dilation in achalasia: A systematic review and meta-analysis.Neurogastroenterology and motility · 2019Pooled it
- Efficacy and safety of a novel technique using endoscopic ultrasound-guided fine-needle injection of botulinum toxin and balloon dilation in achalasia.iGIE : innovation, investigation and insights · 2026Article
- Achalasia in Geriatric Patients: A Comprehensive Overview.Digestive diseases and sciences · 2026Review
- The Predilection of Specific Diseases to Affect Different Sections of the Esophagus.Life (Basel, Switzerland) · 2025Review
- Clinical Outcomes of Patients with Achalasia Following Pneumatic Dilation Treatment: A Single Center Experience.Journal of clinical medicine · 2025Article
- Surgical and endoscopic interventions in the management of idiopathic achalasia.The Cochrane database of systematic reviews · 2025Article
- Imaging following endoscopic and surgical treatment of achalasia.Abdominal radiology (New York) · 2025Review
- Safety of a Novel Upper Esophageal Sphincter Balloon Dilator.The Laryngoscope · 2025Article
- Current Approach to Dysphagia: A Review Focusing on Esophageal Motility Disorders and Their Treatment.GE Portuguese journal of gastroenterology · 2023Review
- Safety of Pneumatic Dilation in Older Adults with Achalasia: An International Multicenter Cross-Sectional Study.Journal of clinical medicine · 2023Article
- Role of endoscopy in patients with achalasia.Clinical endoscopy · 2023Review
- Expanding the role of pneumatic dilation for nonachalasia patients: a comparative study.Gastrointestinal endoscopy · 2023Article
- Outcome of sequential dilatation in achalasia cardia patients: a prospective cohort study.Esophagus : official journal of the Japan Esophageal Society · 2022Article
- Achalasia.Nature reviews. Disease primers · 2022Review
- Esophageal Motility Disorders: Current Approach to Diagnostics and Therapeutics.Gastroenterology · 2022Review
- [Endoscopic Management of Dysphagia].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2021Review
- 2019 Seoul Consensus on Esophageal Achalasia Guidelines.Journal of neurogastroenterology and motility · 2020Review
- Insights into the endoscopic management of esophageal achalasia.Therapeutic advances in gastrointestinal endoscopyReview
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsOne of the most used treatments for achalasia is pneumatic dilation of the lower esophageal sphincter to improve esophageal emptying. Multiple treatment protocols have been described with a varying balloon size, number of dilations, inflation pressure, and duration. We aimed to identify the most efficient and safe treatment protocol.
methodsWe performed a systematic review and meta-analysis of studies on pneumatic dilation in patients with primary achalasia. Clinical remission was defined as an Eckardt score ≤3 or adequate symptom reduction measured with a similar validated questionnaire. We compared the clinical remission rates and occurrence of complications between different treatment protocols.
resultsWe included 10 studies with 643 patients. After 6 months, dilation with a 30-mm or 35-mm balloon gave comparable mean success rates (81% and 79%, respectively), whereas a series of dilations up to 40 mm had a higher success rate of 90%. Elective additional dilation in patients with insufficient symptom resolution was somewhat more effective than performing a predefined series of dilations: 86% versus 75% after 12 months. Perforations occurred most often during initial dilations, and significantly more often using a 35-mm balloon than a 30-mm balloon (3.2 vs 1.0%); P = 0.027. A subsequent 35-mm dilation was safer than an initial dilation with 35 mm (0.97% vs 9.3% perforations), P = 0.0017.
conclusionsThe most efficient and safe method of dilating achalasia patients is a graded approach starting with a 30-mm dilation, followed by an elective 35-mm dilation and 40 mm when there is insufficient symptom relief.
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Registered trials
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