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Treatment with botulinum toxin of octo‐nonagerians with oesophageal achalasia: a two‐year follow‐up study
Author(s) -
BASSOTTI G.,
D'ONOFRIO V.,
BATTAGLIA E.,
FIORELLA S.,
DUGHERA L.,
IAQUINTO G.,
MAZZOCCHI A.,
MORELLI A.,
ANNESE V.
Publication year - 2006
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2006.02907.x
Subject(s) - medicine , achalasia , botulinum toxin , esophageal sphincter , surgery , quality of life (healthcare) , esophagus , sphincter , gastroenterology , anesthesia , reflux , disease , nursing
Summary Background Treatment of oesophageal achalasia with intrasphincteric injections of botulinum toxin has proved to be a successful alternative treatment modality. However, little is known about its long‐term effects in very old patients. Aim To evaluate the effects of such treatment in octo‐nonagerians during a 2‐year follow‐up period. Patients and methods Thirty‐three patients with idiopathic oesophageal achalasia (range 81–94 years) entered the study. After basal evaluation and screening procedures, 100 U of botulinum toxin was injected at the lower oesophageal sphincter, and the procedure was repeated 1 month later. Data were collected at baseline and were compared after 1 and 2 years following the procedure. Results Seventy‐eight per cent of patients were considered responders at 1 year and 54% were considered responders at 2 years. The weight gain at the end of the follow‐up period was 2 (0–3) kg. No significant relationship was found between baseline lower oesophageal sphincter pressure and symptoms score after 1 and 2 years of follow‐up; moreover, no major complications of botulinum toxin therapy were reported. Conclusion Treatment of very old achalasic patients with botulinum toxin is safe, effective and yields good quality of life in a substantial proportion of these subjects.