[Esophageal achalasia: what to do, the balloon or the scalpel?]

In this paper we review the different options published in the world literature regarding the treatment of achalasia of the esophagus. It is concluded that pneumatic dilatation and Heller's operation are the only valid possibilities for primary treatment of the disease. The specific indications for each procedure are also being set. The cost analysis in our country is determined, arriving to the conclusion that pneumatic dilation has a direct cost of A$968 (expectant cost up to A$1.144); and laparoscopic Heller's operation A$2.250. Our personal experience on 120 pneumatic dilatations is analyzed and compared with that of the literature, arriving to the conclusion that our results are similar to the ones of the main available papers.