Guest guest Posted February 15, 2003 Report Share Posted February 15, 2003 I have been told repeatedly by many doctors that Botox only complicates surgery later. Sometime preventing Lap surgery and forcing the open procedure due to scaring. That seems to be the popular opinion of Gastro's I have talked to. JC Botox vs myotomy > I'm about to get a second botox treatment. The first one worked with > limited sucess for almost 11 months. Does anyone know of any reason > (s) not to get the treatment done again. I had one surgeon tell me it > would make a future myotomy more difficult. Another said it didn't > make a difference. Does anyone have any info or experience about the > pros or cons of multiple botox treatments? Like everyone, I'm really > just trying to postpone the eventual myotomy. You could try looking at the following studies: Long-term results and prognostic factors in the treatment of achalasia with botulinum toxin. Neubrand M, Scheurlen C, Schepke M, Sauerbruch T. Endoscopy 2002 Jul;34(7):519-23 Long-term follow-up of achalasia patients treated with botulinum toxin. D'Onofrio V, Miletto P, Leandro G, Iaquinto G. Dig Liver Dis 2002 Feb;34(2):105-10 Achalasia treatment in the elderly: is botulinum toxin injection the best option? Zarate N, Mearin F, Baldovino F, Armengol JR, Malagelada JR. Eur J Gastroenterol Hepatol 2002 Mar;14(3):285-90 If you search at www.pubmed.com using botox and achalasia you'll find loads of studies to read through. On a quick glance, it seems that botox is more likely to be effective in older patients than younger but that pneumatic dilation is likely to work out cheaper/more cost-effective in the long run. I couldn't find a study which compared myotomy and botox but this study: 100 consecutive minimally invasive Heller myotomies: lessons learned. Sharp KW, Khaitan L, Scholz S, Holzman MD, s WO. Ann Surg 2002 May;235(5):631-8; discussion 638-9 Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA. ken.sharp@... covered patients who had previously had dilations (51/100) and botox injections (23/100). Unfortunately the abstract I can access doesn't break down the post-myotomy results by pre-myotomy treatments although that may be in the full study if you can get it. Maybe Ken Sharp (the email address quoted on pubmed would be happy to send out a copy if someone ocntacted him, -- Sue (who should be doing research for a labour and birth essay!) Mum to Stephi, 6yo Nottingham UK Quote Link to comment Share on other sites More sharing options...
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