title: [Achalasia: role of endoscopic therapy and surgery].
abstract: Pneumatic dilation of achalasia has a same medium-term efficacy than surgery and is commonly proposed as the first-line treatment. Intra-sphincteric injection of botulinum toxin is reserved for elderly patients with serious comorbidities. Per-endoscopic myotomy is possible but needs to be evaluated by further studies. Laparoscopic Heller's myotomy in first intension is reserved for young patients less than 40 years. Results of Heller's myotomy are not modified by prior endoscopic treatment or by mega-esophagus. Better surgery results are shown in recent and severe achalasia.
authors.affiliation: CHU Cochin Port Royal, université Sorbonne Paris V, faculté de médecine, service de gastroentérologie, 75014 Paris, France.
authors.forename: Leila
authors.initials: L
authors.lastname: Abbes
authors.forename: Mahaut
authors.initials: M
authors.lastname: Leconte
authors.forename: Romain
authors.initials: R
authors.lastname: Coriat
authors.forename: Bertrand
authors.initials: B
authors.lastname: Dousset
authors.forename: Stanislas
authors.initials: S
authors.lastname: Chaussade
authors.forename: Marianne
authors.initials: M
authors.lastname: Gaudric
mesh_terms: D000328:Adult; D000367:Age Factors; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D004106:Dilatation / Q000379:methods; D004931:Esophageal Achalasia / Q000601:surgery / Q000628:therapy*; D004939:Esophageal Perforation / Q000209:etiology; D049630:Esophageal Sphincter, Lower / Q000187:drug effects / Q000601:surgery; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000601:surgery; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D009130:Muscle, Smooth / Q000601:surgery; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
chemical_list: D019274:Botulinum Toxins, Type A