Predictors of outcome of pneumatic dilation in achalasia Kaveh Farhoomand, Jason T Connor, Joel E Richter, Edgar Achkar, Michael F Vaezi  Clinical Gastroenterology and Hepatology  Volume 2, Issue 5, Pages 389-394 (May 2004) DOI: 10.1016/S1542-3565(04)00123-5

Figure 1 Flow chart for patients and therapy. Seventy-five patients underwent Rigiflex balloon dilation; 68 patients began with a 3.0-cm balloon, of whom 34 patients required the larger 3.5-cm balloon, 29 patients required no further therapy, and 5 patients were referred to surgery (Heller myotomy). Seven patients started with the 3.5-cm balloon. Thus, combined with the 34 patients in whom pneumatic dilation (PD) failed with the 3.0-cm balloon, 41 subjects underwent dilation with the 3.5-cm balloon; 24 of these patients required no additional therapy, 9 patients underwent surgery, and the remaining 8 patients underwent PD with the 4.0-cm balloon. In 1 patient, the 4.0-cm balloon failed and the patient underwent surgery, whereas the remaining 7 patients underwent no additional therapy. Clinical Gastroenterology and Hepatology 2004 2, 389-394DOI: (10.1016/S1542-3565(04)00123-5)

Figure 2 Kaplan-Meier curves for time to retreatment. Patients who underwent pneumatic dilation (PD) with the 3.0-cm balloon alone did poorly compared with those who underwent subsequent dilation with the larger sized balloons. The majority of failures for the 3.0-cm balloon occurred early after therapy. Clinical Gastroenterology and Hepatology 2004 2, 389-394DOI: (10.1016/S1542-3565(04)00123-5)

Figure 3 Barium column height change before and after dilation in patients requiring no additional therapy and those who were retreated. In patients who required no additional treatment, barium column height was reduced significantly after therapy, whereas this was not the case in those requiring treatment. Fifteen of 23 patients (65%) requiring no additional therapy had complete emptying of barium after therapy; however, this was true in only 4 of 31 patients (13%) requiring additional treatment (P = 0.0001). The diamonds to the side of data points represent mean barium column heights. Clinical Gastroenterology and Hepatology 2004 2, 389-394DOI: (10.1016/S1542-3565(04)00123-5)

Figure 4 Probability of additional treatment after 3.0-cm balloon dilation by age and sex for (A) all patients with achalasia (n = 75) and (B) those without previous bougie dilation (n = 53). The solid bold line represents the probability of repeated dilation for men compared with the same probability for women of the same age. Initial dilation with the 3.0-cm balloon was more likely to fail in younger men, and they required repeated treatment for both analyses. The 2 probabilities approach each other for middle-aged patients in the analysis of patients without previous bougie and near the age of 70 years in the analysis involving all patients. M, male; F, female. Clinical Gastroenterology and Hepatology 2004 2, 389-394DOI: (10.1016/S1542-3565(04)00123-5)