[Conservative endoscopic treatment for achalasia of the esophagus. Our experience]

The Authors report their experience in the endoscopic treatment using pneumatic dilatation for 18 patients with achalasia, seen in the period January 1992 August 1995 at the Laboratory of Digestive Endoscopy of the Institute of General Thoracic and Vascular Surgery of the University of Parma. Ten were males and 8 females, age range 23-79 years (average age 48 yrs.). The most common symptoms was dysphagia, all patients were radiologically and manometrically studied confirming the clinical and endoscopic diagnosis. All underwent pneumatic dilatation under endoscopic control. In all, 36 dilations were carried out without registering complications related to the method. A maximum follow-up of 30 months confirmed a good-excellent outcome in 89% of cases. In 3 cases a gastroesophageal reflux symptomatology was registered, but successfully treated medically. The Authors conclude that the pneumatic dilation for achalasia is to be considered the treatment of choice, leaving the surgical approach only for cases resistant to such treatment.