[Esophageal achalasia: review of the results after 15 years' experience]

The purpose of this paper is to evaluate the experience acquired along a 15 years period (1971-1985) in the treatment of achalasia of the esophagus. One hundred and fifty six patients were evaluated. The average age was 50.8 years, and the M/F ratio 0.9/1. Dysphagia was present in 100%, regurgitation in 78.2%, weight loss in 61.5%, and chest pain in 50% of the cases, being the main symptoms. Serology for Chagas disease was positive in 21.2% of the patients. When classified by radiologic criteria the groups were: grate I 18.5%, grate II 53.8%, grate III 14.7% and grate IV 12.8%. The high pressure zone was X 23 mmHg (N 14.8 mmHg) pre dilatation. The incidence of vigorous achalasia was 5.7% and the urecholine test was positive in 61.1%. Only 95 patients were submitted to pneumatic dilatation, and this is the group that we shall analyze in detail. We performed 110 dilatations, since 80 patients were dilated once and 15 received 2 dilatations. The high pressure zone post dilatations was X 12.5 mmHg. We obtained good results in 82.1%, regular in 3.1% and bad results in 14.7% of the patients. The morbidity was 4.5% (3 perforations and 2 gastroesophageal reflux), and the mortality 0.9%. There was relapse in 26.3% of the cases. In 53.3% of the patients submitted to a second dilatation we obtained good results. The average hospital stay was 2.5 days, and the follow up X 32.4 months. Thirty nine patients were sent to surgery with good results in 82%, regular in 2.5%, and bad in 15.6%. The morbidity was 15.3% and the mortality 5.1%.(ABSTRACT TRUNCATED AT 250 WORDS)