Achalasia 2016: Treatment Alternatives

Area of Science:

• Gastroenterology
• Surgical Innovation
• Esophageal Motility Disorders

Background:

• Achalasia treatment has evolved significantly with surgical advancements.
• Minimally invasive techniques have become prominent in managing achalasia.
• Laparoscopic Heller myotomy (LHM) largely replaced pneumatic dilatation (PD) after 1991.

Purpose of the Study:

• To review and compare the advantages and disadvantages of different achalasia treatment modalities.
• To highlight the evolution of surgical and endoscopic interventions for achalasia.
• To emphasize the importance of personalized treatment strategies.

Main Methods:

• Comparative review of laparoscopic Heller myotomy (LHM), pneumatic dilatation (PD), and per oral endoscopic myotomy (POEM).
• Analysis of historical trends and current practices in achalasia management.
• Discussion of patient-specific factors influencing treatment selection.

Main Results:

• Laparoscopic Heller myotomy (LHM) is a widely adopted minimally invasive approach.
• Per oral endoscopic myotomy (POEM) represents a further endoscopic advancement.
• Pneumatic dilatation (PD) remains a viable, albeit less common, treatment option.

Conclusions:

• Each achalasia treatment technique (LHM, PD, POEM) has distinct benefits and drawbacks.
• The optimal treatment choice for achalasia is patient-dependent.
• Multidisciplinary team involvement is crucial for tailoring individualized achalasia care.