Abstract
remains unclear, but should also be standardised as well. Similar to Drs Vanuytsel, Boeckxstaens and Tack, we also advocate starting with a 30-mm balloon. Just as their recently published experience supports this approach, data from our laboratory previously demonstrated that in a randomised study in 24 achalasia patients comparing balloon dilator sizes used during initial pneumatic dilatation, at the end of 6 months, there was equal response to either a 30or 35-mm dilator. Interesingly, there was similar response to 15or 60-s duration of inflation. We feel that pneumatic dilation still represents an important therapeutic option in achalasia but its role can only be more precisely defined with careful standardised studies. We are delighted that leaders in the field, such as Drs Vanuytsel, Boeckxstaens and Tack support these views and are attempting to define the role of dilation by their important work.
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