Esophageal achalasia: retrospective analysis of treatment during 2000–2010
<p><strong>BACKGROUND<br /> </strong>Esophageal achalasia (EA) is a primary esophageal motility disorder of unclear aetiology. Standard treatments of EA are: pneumatic balloon dilation (PBD) of the lower esophageal sphyncter (LES) and surgical cleaving of the muscle by Heller...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Slovenian Medical Association
2011-10-01
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| Series: | Zdravniški Vestnik |
| Online Access: | http://vestnik.szd.si/index.php/ZdravVest/article/view/199 |
| Summary: | <p><strong>BACKGROUND<br /> </strong>Esophageal achalasia (EA) is a primary esophageal motility disorder of unclear aetiology. Standard treatments of EA are: pneumatic balloon dilation (PBD) of the lower esophageal sphyncter (LES) and surgical cleaving of the muscle by Heller myotomy. Although the treatment effectively cures dysphagia, the symptoms recur in about a half of the patients. Our point of interest was long-term effectiveness of EA treatment at our department. </p><p><strong>METHODS</strong><br />We made a retrospective analysis of EA patients treated at our department of thoracic surgery during the 2000–2010 period.</p><p><strong>RESULTS</strong><br />In 11 years we performed 187 PBD and 22 laparoscopic myotomies (LM) in 148 patients. Three years after the procedure 65 % of patients after PBD and 90 % of patients after LM showed no signs of disease. The risk of recurrence was 3.56-times greater (p = 0.03) after PBD (in comparison to LM), whereas patients older than 50 years bear 0.51-times lower risk (p = 0.02). The most significant complicatios were esophageal perforation in 3 patients (1.6 %) after PBD and gastroesophageal reflux in 3 patients (15 %) after LM.</p><p><strong>CONCLUSIONS</strong><br />PBD is a fast, simple, inexpensive and very efficient method of EA treatment, which can be safely performed in almost every patient. LM is far more expensive and a more complicated method that is more suitable for younger patients, in whom PBD is less effective.</p> |
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| ISSN: | 1318-0347 1581-0224 |