title: Pneumatic balloon dilation therapy is as effective as esophagomyotomy for achalasia.
abstract: For many years different treatments have been used for achalasia. However, esophagomyotomy (ESM) and pneumatic balloon dilation (PBD) have been considered the treatments of choice. Despite new research, some controversies still exist. We compared patients who underwent open ESM (n=19) with those who underwent PBD (n=45). Data on age, gender, pre- and postprocedure symptoms, clinical manifestations at the time of research, clinical relief, type of surgery, and costs were collected via questionnaire. Open ESMs were performed by two expert surgeons, and PBDs were performed by one gastroenterologist. There was no significant difference in clinical symptoms and in patient satisfaction between the groups before and after the procedures except for chest pain. Clinical relief status (excellent, good, moderate, or poor) was comparable (26%, 42%, 15%, 15% for open ESM group and 40%, 20%, 24%, 15% for PBD group). Postprocedure complications were not significantly different between the two groups. Clinical rates of relapse for open ESM and PBD groups were 38.6% and 25%, respectively. There were no serious complications. There was no significant difference between the clinical outcomes of the two methods of achalasia treatment. Considering other important factors such as a shorter period of hospitalization, fewer sick days off, risk of general anesthesia, and cosmetic sequels, PBD is preferable for the majority of patients.
authors.affiliation: Isfahan University of Medical Science, Isfahan, Iran.
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Emami
authors.forename: Mostafa
authors.initials: M
authors.lastname: Raisi
authors.forename: Jaleh
authors.initials: J
authors.lastname: Amini
authors.forename: Abbas
authors.initials: A
authors.lastname: Tabatabai
authors.forename: Mehran
authors.initials: M
authors.lastname: Haghighi
authors.forename: Hamid
authors.initials: H
authors.lastname: Tavakoli
authors.forename: Mozafar
authors.initials: M
authors.lastname: Hashemi
authors.forename: Mehdi
authors.initials: M
authors.lastname: Fude
authors.forename: Ziba
authors.initials: Z
authors.lastname: Farajzadegan
authors.forename: Vahid
authors.initials: V
authors.lastname: Goharian
mesh_terms: D000328:Adult; D002404:Catheterization / Q000379:methods*; D003680:Deglutition Disorders / Q000175:diagnosis; D004931:Esophageal Achalasia / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D009130:Muscle, Smooth / Q000503:physiopathology* / Q000601:surgery*; D017060:Patient Satisfaction; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires