Abstract
We review the treatment of esophageal achalasia by means of pneumatic dilatation (PD), analyzing its results and comparing them with those of the literature. We conclude that our personal experience is similar to that of the literature: PD and surgery produce similar results (67-95%), morbidity (2-9.5%), and mortality (0.7-1%); and PD is cheaper than surgery. According to these conclusions, we believe that the decision of the appropriate treatment should be based on a combination of the choice of the properly informed patient and the operator's experience. However, we also conclude that surgery is mandatory in selected cases, such as achalasia associated with hiatus hernia, esophageal diverticula and neoplasia, history of previous PD failure (since in our experience the results after a second PD are very poor), postoperative relapse, and patients with grade IV mega-esophagus according to Resano-Malenchini's classification.
References
Dec 1, 1992·Gastroenterology·V F EckardtG Bernhard
Jan 1, 1991·Gastrointestinal Endoscopy·B McJunkinJ E McJunkin
Jun 1, 1991·Gut·G CocciaM Dodero
Jan 1, 1988·Surgical Endoscopy·E Bovero, A Farese
Aug 1, 1986·Gut·J CoxJ R Bennett
Jul 1, 1993·Digestive Diseases and Sciences·S StupnikA García
Jan 1, 1993·Digestive Diseases and Sciences·H P ParkmanS Cohen
Jul 1, 1996·Gut·E BorottoD Couturier
May 1, 1997·Digestive Diseases and Sciences·C A BurkeG W Falk
May 1, 1997·Surgical Endoscopy·R C Bell
Jul 22, 1998·The American Journal of Gastroenterology·A A KhanD O Castell
Dec 3, 1998·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·M G PattiL W Way
Apr 7, 1999·Journal of Clinical Gastroenterology·R O DantasE A Donadi
May 11, 1999·The American Journal of Gastroenterology·E H MetmanJ P Barbieux
Sep 29, 1999·Gastroenterology·J C GoinE Borda
Sep 29, 1999·Gastrointestinal Endoscopy·R PanaccioneH G Preiksaitis
Oct 3, 1999·Digestive Diseases and Sciences·R M GideonJ Yarze
Oct 16, 1999·Annals of Surgery·M G PattiL W Way
Dec 22, 1999·The American Journal of Gastroenterology·M F Vaezi, J E Richter
Mar 15, 2000·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·D R ClohisyR C Thompson
Aug 2, 2000·Archives of Surgery·M S YamamuraB C Sheppard
Aug 30, 2000·Arquivos De Gastroenterologia·R O Dantas
Oct 29, 2000·The American Journal of Gastroenterology·T F ImperialeJ E Richter
Nov 4, 2000·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·D R HuntI J Coo
Jun 20, 2001·Gut·S J Spechler, D O Castell
Nov 7, 2003·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·T FujiiM Morimatsu
Citations
Dec 25, 2008·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Sanjay Agrawal, Paul Super
Oct 4, 2005·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·N A KimchiY Avni
Nov 22, 2008·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·J A TusetE Medina
Oct 4, 2012·The American Journal of Gastroenterology·Kristle L LynchPeter J Kahrilas
Feb 8, 2006·Annals of the Royal College of Surgeons of England·P J Lamb, S M Griffin