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| 1 | Endoscopic balloon catheter dilatation via retrograde or static technique is safe and effective for cricopharyngeal dysfunction显示文摘AIM To evaluate the safety and efficacy of upper esophageal sphincter(UES) dilatation for cricopharyngeal(CP) dysfunction. To determine if:(1) indication for dilatation; or(2) technique of dilatation correlated with symptom improvement.METHODS All balloon dilatations performed at our institution from over a 3-year period were retrospectively analyzed for demographics, indication and dilatation site. All dilatations involving the UES underwent further review to determine efficacy, complications, and factors that predict success. Dilatation technique was separated into static(stationary balloon distention) and retrograde(brusque pull-back of a fully distended balloon across the UES).RESULTS Four hundred and eighty-eight dilatations were reviewed. Thirty-one patients were identified who underwent UES dilatation. Median age was 63 years(range 27-81)and 55% of patients were male. Indications included dysphagia(28 patients), globus sensation with evidence of UES dysfunction(2 patients) and obstruction to echocardiography probe with cricopharyngeal(CP)bar(1 patient). There was evidence of concurrent oropharyngeal dysfunction in 16 patients(52%) and a small Zenker's diverticula(≤ 2 cm) in 7 patients(23%). Dilator size ranged from 15 mm to 20 mm. Of the 31 patients, 11 had dilatation of other esophageal segments concurrently with UES dilatation and 20 had UES dilatation alone.Follow-up was available for 24 patients for a median of 2.5 mo(interquartile range 1-10 mo), of whom 19 reported symptomatic improvement(79%). For patients undergoing UES dilatation alone, follow-up was available for 15 patients, 12 of whom reported improvement(80%).Nineteen patients underwent retrograde dilatation(84%response) while 5 patients had static dilatation(60%response); however, there was no significant difference in symptom improvement between the techniques(P = 0.5).Successful symptom resolution was also not significantly affected by dilator size, oropharyngeal dysfunction,Zenker's diverticulum, age or gender(P > 0.05). The only complication noted was uvular edema and a shallow ulcer after static dilatation in one patient, which resolved spontaneously and did not require hospital admission.CONCLUSION UES dilatation with a through-the-scope balloon by either static or retrograde technique is safe and effective for the treatment of dysphagia due to CP dysfunction. To our knowledge, this is the first study evaluating retrograde balloon dilatation of the UES. | Vinay Chandrasekhara Joyce Koh Lakshmi Lattimer Kerry B Dunbar William J Ravich John O Clarke | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，4： | 6 |
| 2 | 显示文摘 | Pasricha PJ Rai R Ravich WJ | 1996 | Gastroenterology1996，110，5： | 1 |
| 3 | 显示文摘 | Pasricha PJ Rai R Ravich WJ | 1996 | Gastroenterology1996，110，5： | 1 |
| 4 | Botulinum toxin for achaiasia: Long term follow-up and predictors of outcome显示文摘 | Paricha P J Rai R Ravich WJ | 1966 | Gastroenterology1966，110，1： | 1 |
| 5 | Intrasphincteric botulinum toxin for the treatment of achalasia显示文摘 | Pasricha PJ Ravich WJ Hendrix TR | 1995 | N Engl J Med1995，332，12： | 1 |
| 6 | Alkaline protease production by submerged fermentation in stirred tank reactor using Bacillus licheniformis NCIM-2042 显示文摘 | Ravich R Potumar T Annapurna J | 2006 | Biochemical Engineering Journal2006，5，： | 1 |
| 7 | Impact of pro- cessing of red beet on betalain content and antioxidant activity显示文摘 | RAVICH K SAW N M M T MOHDALY A A A | 2013 | Food Res hat2013，50，2： | 1 |
| 8 | Effects of intrasphincteric botulinum toxin on the lower esophageal sphincter in piglets 显示文摘 | Pasricha PJ Ravich W J Kalloo AN | 1993 | Gastroenterology1993，105，4： | 1 |
| 9 | Intrasphincteric botulinum toxin for the treatment of achalasia 显示文摘 | Pasricha PJ Ravich WJ Hendrix TR Sostre S Jones B Kalloo AN | 1995 | N Engl J Med1995，332，12： | 1 |
| 10 | Botulinum toxin for achalasia: Long-term outcome and predictors of response显示文摘 | PASRICHA PJ RAI R RAVICH WJ | 1996 | Gas- troenterology1996，110，5： | 1 |
| 11 | Mechanical properties of carbon nanoparticle reinforced elastomers显示文摘 | Frogley M D Ravich D Wagner H D | 2003 | Composites Science and Technology2003，63，11： | 1 |
| 12 | Effects of intrasphincteric botulinum toxin on the lower esophageal sphincter in piglets显示文摘 | Pasricha P J Ravich W J Kalloo AN | 1993 | Gastroenterology1993，105，4： | 1 |
| 13 | Botulinum toxin for achalasia: long-term outcome and predictors of response显示文摘 | Pasricha PJ Rai R Ravich WJ | 1996 | Gastroenterology1996，110，5： | 1 |
| 14 | Thermoelectric Figure of Merit of N-Type PbTe显示文摘 | Efimova B A Kolomoet La Ravich Y I | 1971 | Soviet Physics Semiconductors-Ussr1971，4，： | 1 |
| 15 | Mechanical properties of carbon nanoparticle-reinforced elastomer显示文摘 | Frogley M D Ravich D H Wagner D | 2003 | Composites Science and Technology2003，63，： | 1 |
| 16 | Resonant Scattering of Carriers in IV-VI Semiconductors显示文摘 | Kaidanov V I Nemov S A Ravich Y I | 1992 | Soviet Physics Semiconductors-Ussr1992，26，： | 1 |
| 17 | Deep and Resonance States in A IV B VI Semiconductors显示文摘 | Kaidanov V I Ravich Y I | 1985 | Soviet Physics-Uspekhi1985，28，： | 1 |
| 18 | Intrasphincteric butulinnum toxin for the tyeatment of achalasia 显示文摘 | PASRICHA P J RAVICH W J HENDRIX T R | 1995 | Nengl J Med1995，322，12： | 1 |
| 19 | Botulinum toxin for achalasia: long term outcome and predictors of response 显示文摘 | Pasricha PJ Rai R Ravich WJ | 1996 | Gastroenterology1996，110，5： | 1 |
| 20 | Botulinum toxin for achalasia:long-term outcome and predictors of response 显示文摘 | Pasricha P J Rai R Ravich W J | 1998 | Gastroenterology1998，110，12： | 1 |
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