Official websites use. Share sensitive information only on official, secure websites. Correspondence: nbar mgh. Background: Pneumatic dilation PD is an effective first line treatment option for many patients with achalasia. PD use may be limited in adults with achalasia who are older than 65 because of concern for adverse events AE , and less efficacious therapies are often utilized.
We explored the periprocedural safety profile of PD in older adults. Methods: An international real world cross-sectional study of patients undergoing PD between โ in two tertiary centers. Thirty-day AEs were compared between older adults 65 and older with achalasia and younger patients. Results: A total of patients underwent PDs. In PDs, 18 5. No bleeding or death occurred within 30 days.
Perforation rates were similar in both age groups and across achalasia subtypes. Advanced age was protective of benign chest pain complications in univariate analysis, and the limited number of AEs precluded multivariable analysis.
Conclusions: The safety of PD in older adults is at least comparable to that of younger patients and should be offered as an option for definitive therapy for older patients with achalasia. Our results may affect informed consent discussions. Achalasia is a neurodegenerative disease resulting in impaired lower esophageal sphincter LES relaxation and esophageal food retention predisposing patients to aspiration-related complications.
Standard of care invariably includes LES disruption, achieved by one of three modalities: serial pneumatic dilations PDs which are performed during upper endoscopy, or endoscopic or surgical myotomy [ 1 , 2 , 3 ]. Notably, in recent years, peroral endoscopic myotomy, originating from Japan, has gained increasing favor worldwide as an efficacious and safe therapeutic modality for achalasia [ 4 ].
