title: Recent trends in the management of achalasia.
abstract: Radical treatment for achalasia is currently unavailable. At present, most palliative procedures are designed improve the passage of food through the gastroesophageal junction and thereby alleviate symptoms. Drug therapy is of limited, transient effectiveness. Pneumatic dilation (PD) is considered superior to endoscopic botulinum toxin injection (EBTI). The mainstay of surgical treatment for achalasia is laparoscopic Heller myotomy (LHM) with fundoplication, currently considered superior to PD. Per oral endoscopic myotomy (POEM), a "state-of-the-art" procedure for minimally invasive surgery, holds great promise for the future management of achalasia. Definitive conclusions regarding the benefits and risks of currently available treatments for achalasia must await the accumulation of evidence from well-designed clinical trials.
authors.affiliation: Department of Surgery, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan. katada@kitasato-u.ac.jp
authors.forename: Natsuya
authors.initials: N
authors.lastname: Katada
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sakuramoto
authors.forename: Keishi
authors.initials: K
authors.lastname: Yamashita
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Shibata
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Moriya
authors.forename: Shiro
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Watanabe
mesh_terms: D004106:Dilatation / Q000379:methods; D004931:Esophageal Achalasia / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy; D004943:Esophagogastric Junction / Q000601:surgery*; D004944:Esophagoplasty / Q000379:methods; D018662:Fundoplication / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D016896:Treatment Outcome