[Dilatation treatment of achalasia as initial therapy. Results of a prospective study]

From 1972 to 1991 primary dilatation therapy was investigated in a prospective study in 77 patients suffering from achalasia of the gastroesophageal sphincter. The patients were followed up continuously and the median follow-up period was ten years. 70% of patients were symptom-free after dilatation therapy at the time of the last follow-up examination, whereby 50% were cured of symptoms after a single dilatation. 27% required surgery after unsuccessful dilatation therapy. The probability of avoiding operation after dilatation therapy within 15 years of diagnosis of achalasia was 73%. The clinical symptomatology at diagnosis graded according to a scheme from I to IV, was significantly worse in patients requiring an operation (Wilcoxon test, p < 0.0005). The data of esophageal manometry were of no prognostic relevance.