Esophageal achalasia in the Veneto region: epidemiology and treatment. Epidemiology and treatment of achalasia.
BACKGROUND
Achalasia is a rare esophageal motility disorder, incurable but amenable to palliative treatments to relieve dysphagia. Given the rarity of the disease, there is a paucity of data from population-based studies on incidence and outcome of the two treatments most commonly used in clinical practice, i.e., endoscopic pneumatic dilation (PD) and surgical myotomy (SM).


METHODS
A retrospective longitudinal study was conducted on the Veneto region, in north-eastern Italy. All patients with achalasia as their primary diagnosis between 2001 and 2005 were identified and their demographics and treatment details obtained.


RESULTS
The overall incidence of achalasia was 1.59 cases/100,000/year. Achalasia patients were mainly seen at University Hospitals. Fifty-five percent of the patients received treatment, 23.3% SM and 31.8% PD. The cumulative risk of any subsequent intervention for achalasia was 20% in treated patients (29.7% in patients treated primarily with PD and 4% in patients treated with SM first).


CONCLUSIONS
The epidemiology of achalasia in the Veneto Region is in line with the situation reported elsewhere and did not change between 2001 and 2005. Achalasia patients are mostly seen at University Hospitals. We observed a greater risk of subsequent intervention for patients previously treated with PD compared with SM.
Innovation and Research Unit, Health and Social Agency of Veneto Region, Venice, Italy.
Nicola
N
Gennaro
Giuseppe
G
Portale
Costantino
C
Gallo
Stefano
S
Rocchietto
Valentina
V
Caruso
Mario
M
Costantini
Renato
R
Salvador
Alberto
A
Ruol
Giovanni
G
Zaninotto
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D004931:Esophageal Achalasia / Q000453:epidemiology* / Q000628:therapy*; D049630:Esophageal Sphincter, Lower / Q000601:surgery*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult