To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: DDW: Botulinum Injections for Achalasia Work from Antegrade or Retroflex Approaches URL: http://www.pslgroup.com/dg/233246.htm Doctor's Guide May 21, 2003
By Ed Susman ORLANDO, FL -- May 21, 2003 -- Doctors from the Czech Republic demonstrated that injections of botulinum toxin into the sphincter of the oesophagus -- whether approached antegrade or both antegrade and retroflex -- produce long-term relief for patients with achalasia. Jan Martinek, MD, assistant professor at Charles University and staff physician, department of hepatogastroenterology, Institute for Clinical and Experimental Medicine, Prague, presented the findings here May 19th during Digestive Disease Week 2003. The trial included 35 patients with oesophageal spasticity that made swallowing difficult. Dr. Martinek reported that both procedures appear to have equal efficacy. "That means we can use the retroflex approach when we are faced with patients for whom an antegrade procedure is anatomically difficult," he said. He injected botulinum toxin type A (Dysport) using the antegrade view in 18 patients, achieving a response in 17 of them. Seven of these patients relapsed 6 to 15 months later; the other 10 patients have not had a relapse in 6 to 23 months. In another 17 patients, he injected the toxin using both antegrade and retroflex views. All patients responded. Five patients relapsed after 4-15 months; the remaining 12 patients have not relapsed in 6 to 22 months. He said the differences between the two groups did not reach statistical significance. "This is not a cure," Dr. Martinek said. "We expect that within 4 years all the patients will have relapse. However, we did show that the modified botulinum toxin administration technique combining injection from both antegrade and retroflexed views is as effective as the standard botulinum toxin injection from the antegrade view. "We did the study because it has been suggested that standard botulinum injection from the antegrade view only may not result in adequate lower oesophageal sphincter infiltration by toxin and that the modified injection technique combining botulinum injection from both antegrade and retroflexed views might be better." Dr. Martinek said the botulinum procedure takes 10 minutes and involves little risk to the patient. This procedure has become a popular treatment for achalasia because the other treatments -- balloon dilation and surgery -- carry additional risks. He added that the other treatments may still be performed if botulinum injections fail to correct achalasia. [Study title: Injection of Botulinum Toxin (BT) from Antegrade View or from Both Antegrade and Retroflexed Views? A Randomized, Double-Blind Study in Patients with Achalasia. Abstract 102913] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.