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Achalasia: dilation, injection or surgery?

A Peracchia¹, L Bonavina

¹Istituto di Chirurgia Generale e Oncologia Chirurgica, Milano, Italy.

Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie

|June 14, 2000

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Achalasia, a condition affecting the esophageal myenteric plexus, is treated by reducing lower esophageal sphincter resistance. Laparoscopic surgery is increasingly preferred over pneumatic dilation or Heller myotomy for achalasia treatment.

Area of Science:

Gastroenterology
Esophageal Motility Disorders

Background:

Achalasia stems from irreversible damage to the esophageal myenteric plexus.
Treatment aims to decrease lower esophageal sphincter (LES) resistance for bolus passage.

Purpose of the Study:

To review current treatment strategies for achalasia.
To evaluate the emerging role of laparoscopic surgery in achalasia management.

Main Methods:

Literature review of endoscopic and surgical interventions for achalasia.
Analysis of current clinical trends and expert opinion regarding treatment choices.

Main Results:

Definitive treatments include pneumatic dilation and Heller myotomy.
Laparoscopic surgery is gaining traction as a primary intervention.

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Controlled comparative studies between modern techniques are currently lacking.

Conclusions:

Laparoscopic surgery is emerging as the preferred initial treatment for achalasia.
Further comparative studies are needed to definitively establish the superiority of any single modality.