Treatment experience with a novel 30-mm hydrostatic balloon in esophageal dysmotility: a multicenter retrospective analysis

BACKGROUND AND AIMS The newest addition in the management of achalasia and esophagogastric junction outflow obstruction (EGJOO) is a 30 mm hydrostatic balloon dilator that uses impedance planimetry technology. It allows for the measurement of the diameter and cross-sectional area to determine effective dilation. We aimed to (1) determine the clinical success (defined as a decrease in Eckardt score to ≤3) in the treatment of esophageal motility disorders; (2) report the safety (rate/severity of adverse events (AEs)).
PATIENTS AND METHODS This is a retrospective multicenter study involving 4 centers. Patients with esophageal motility disorders who underwent hydrostatic balloon dilation between January 2015 and October 2018 were included.
RESULTS A total of 51 patients (mean age 54.1 years, female 49%) underwent hydrostatic dilation for achalasia (n=37) or EGJOO (n=14) during the study period. Forty-seven patients had a baseline Eckardt score with a median of 5 (3-8) (achalasia, n=35: 6 [3-8]; EGJOO, n=12: 4 [3.25-6.5]). Clinical success was achieved in 60% of cases (achalasia vs EGJOO: 68.4% vs 33.3% p=0.18). Dilation resulted in a significant decrease in the median Eckardt score from 5 (3-8) to 1.5 (1-4.75) (p<0.001). Patients with achalasia had a decrease in Eckardt score from 6 (3-8) to 1 (1-4) (p<0.001), whereas those with EGJOO experienced no significant change. One patient had mild postprocedure chest pain.
CONCLUSIONS The hydrostatic balloon dilator is a new tool in our armamentarium to treat esophageal motility disorders. This is the first multicenter study showing the device to be safe and moderately efficacious.

as reported in: Gastrointest Endosc. 2020 May 14 [Epub ahead of print]