title: An audit of pneumatic dilatation and oesophagomyotomy in patients with achalasia cardia.
abstract: The role of pneumatic dilatation and oesophagomyotomy in the management of achalasia cardia was evaluated. Twenty patients with achalasia cardia managed either by pneumatic dilatation (n = 10) and oesophagomyotomy (n = 10) were studied. Patients undergoing dilatation were followed up for a mean of 20 months (12-30 months) and those undergoing myotomy for 17 months (6-48 months). The patients were evaluated clinically, radiologically and endoscopically. Relief of dysphagia was excellent in 20%, good in 50% and fair in 30% of those who underwent dilatation. In the myotomy group, 60% had an excellent result, 30% had a good result and fair results was observed in 10%. Oesophagitis on endoscopic evaluation, was found in two patients in myotomy group. The diameter of the gastro-oesophageal junction increased from a mean of 2 mm (range 1 to 4 mm) to a mean of 11 mm (range 4 to 15 mm) in dilatation group while in myotomy group it changed from a mean of 2 mm (range 0.5 to 8 mm) to a mean of 9 mm (range 5 to 15 mm). Symptomatic improvement was better after myotomy than after pneumatic dilatation and correlated poorly with radiological features.
authors.affiliation: Department of surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: A
authors.initials: A
authors.lastname: Kumar
authors.forename: J D
authors.initials: JD
authors.lastname: Wig
authors.forename: R
authors.initials: R
authors.lastname: Kochhar
authors.forename: N M
authors.initials: NM
authors.lastname: Gupta
authors.forename: B
authors.initials: B
authors.lastname: Nagi
mesh_terms: D000293:Adolescent; D000328:Adult; D002404:Catheterization; D004931:Esophageal Achalasia / Q000601:surgery / Q000628:therapy*; D004947:Esophagus / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome