INTRODUCTION: The timed barium study (TBS) is used to assess esophageal emptying in patients with achalasia. Improvement in emptying correlates with outcome after endoscopic therapy, but the results of the TBS have been variable after myotomy. Our aim was to evaluate a new method for assessing improvement in emptying after myotomy. METHODS: A TBS was performed before and 3-6 months after myotomy in 30 patients. Emptying was assessed by measuring the percent difference in area of the barium column on films obtained 1 and 5 min after ingesting 150 ml of barium. Initial esophageal clearance was also assessed by comparing the area of the barium column on 1-min images obtained before and after therapy. Both measures were compared to clinical outcome. RESULTS: After myotomy, 21 patients (70%) had no symptoms, four (13%) had mild, and five (17%) had moderate/severe symptoms. Using the standard method, esophageal emptying before and after surgery were not significantly different (25% vs. 37%; p = 0.22) and did not correlate with clinical outcome. In contrast, initial esophageal clearance improved significantly (median 81%) and correlated with clinical outcome. CONCLUSION: Esophageal emptying measured by the standard method is not useful to assess outcome after myotomy. However, initial esophageal clearance correlates well with clinical outcome.
INTRODUCTION: The timed barium study (TBS) is used to assess esophageal emptying in patients with achalasia. Improvement in emptying correlates with outcome after endoscopic therapy, but the results of the TBS have been variable after myotomy. Our aim was to evaluate a new method for assessing improvement in emptying after myotomy. METHODS: A TBS was performed before and 3-6 months after myotomy in 30 patients. Emptying was assessed by measuring the percent difference in area of the barium column on films obtained 1 and 5 min after ingesting 150 ml of barium. Initial esophageal clearance was also assessed by comparing the area of the barium column on 1-min images obtained before and after therapy. Both measures were compared to clinical outcome. RESULTS: After myotomy, 21 patients (70%) had no symptoms, four (13%) had mild, and five (17%) had moderate/severe symptoms. Using the standard method, esophageal emptying before and after surgery were not significantly different (25% vs. 37%; p = 0.22) and did not correlate with clinical outcome. In contrast, initial esophageal clearance improved significantly (median 81%) and correlated with clinical outcome. CONCLUSION: Esophageal emptying measured by the standard method is not useful to assess outcome after myotomy. However, initial esophageal clearance correlates well with clinical outcome.
Authors: S V Kostic; T W Rice; M E Baker; M M Decamp; S C Murthy; L A Rybicki; E H Blackstone; J E Richter Journal: J Thorac Cardiovasc Surg Date: 2000-11 Impact factor: 5.209
Authors: J M de Oliveira; S Birgisson; C Doinoff; D Einstein; B Herts; W Davros; N Obuchowski; R E Koehler; J Richter; M E Baker Journal: AJR Am J Roentgenol Date: 1997-08 Impact factor: 3.959
Authors: Marco G Patti; Maria V Gorodner; Carlos Galvani; Pietro Tedesco; Piero M Fisichella; James W Ostroff; Karen C Bagatelos; Lawrence W Way Journal: Arch Surg Date: 2005-05
Authors: Marisol Luján-Sanchis; Patricia Suárez-Callol; Ana Monzó-Gallego; Inmaculada Bort-Pérez; Lydia Plana-Campos; Luis Ferrer-Barceló; Laura Sanchis-Artero; María Llinares-Lloret; Juan Antonio Tuset-Ruiz; Javier Sempere-Garcia-Argüelles; Pilar Canelles-Gamir; Enrique Medina-Chuliá Journal: World J Gastrointest Endosc Date: 2015-06-10