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• W2921320846 abstract "Introduction: Botulinum injections are an effective treatment option for the elderly and others who may not be able to tolerate more invasive procedures. While botox injection remains relatively safe, it is not without its complications. In this study, we seek to understand the effect of different doses of botox A on the effectiveness and associated complications for achalasia treatment. Methods: This IRB-approved retrospective chart review identified 26 patients of 18 years of age or older diagnosed with achalasia who received botox between 1/2006 and 12/2016. Two excluded patients previously had been treated with pneumatic dilation, POEM, and/or Heller myotomy. Primary outcomes included continued symptom resolution in 1 year and interval period between botox injections or documentation of recurrent symptoms. Side effects were also investigated. Student t-tests were conducted assuming unequal variances, and reported p-values assumed two-tailed testing. Results: Of the 24 patients (mean age 72.3±12.3, mean BMI 27.2±6.5, 50% female), 11 patients received 100 units (mean age 77.3±10.4, mean BMI 25.7±3.3, 45.5% female), 7 patients received 200 units (mean age 71.1±16.3, mean BMI 31.9±6.6, 44.4% female), and 6 patients received other doses. The most common comorbidities were hypertension, hyperlipidemia, GERD, and cancer in all categories. For their first injection, 30.0% vs. 42.9% (p=0.62) of individuals experienced 1-year resolution, and the average interval period between botox injections or documentation of recurrent symptoms was 240.6 vs. 418.8 days (p=0.05) for 100 units vs. 200 units respectively. Complications included cough, pneumomediastinum, small bowel perforation, and peritonitis. Interestingly, these only occurred in the group that received 100 units of botox. In those who received 100 units, 2 eventually received POEMs and 1 eventually received a laparoscopic myotomy. One patient in the 200 unit group eventually received POEM and 1 received a laparoscopic myotomy. Conclusion: Based on this study, it appears that those who receive 200 units may be more likely to have a longer period of time before they receive re-injection or have documented recurrent symptoms. Though those who received less botox seemed to have more complications, this may be confounded by an older group. This study has been limited by the small sample size and its retrospective design. Additional investigation would be helpful to optimize botox doses for patients with achalasia." @default.
• W2921320846 created "2019-03-22" @default.
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• W2921320846 date "2018-10-01" @default.
• W2921320846 modified "2023-09-29" @default.
• W2921320846 title "Response to Varying Doses of Botulinum Toxin Injection in the Treatment of Achalasia" @default.
• W2921320846 doi "https://doi.org/10.14309/00000434-201810001-02776" @default.
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