This article reviews the medical and surgical modalities for the treatment of esophageal achalasia. It compares and critically analyzes the short- and long-term outcomes of pneumatic dilatation and laparoscopic Heller myotomy. Today, laparoscopic Heller myotomy is considered in most centers to be the procedure of choice for the treatment of achalasia. Nevertheless, the success of either procedure is based on the careful selection of the patients and on the surgeon’s and gastroenterologist’s level of expertise.
Stefanidis D, Richardson W, Farrell TM et al. SAGES guidelines for the surgical treatment of esophageal achalasia. Surg Endosc 2012;26:296–311.PubMedCrossRefGoogle Scholar
Patti MG, Fisichella PM, Perretta S et al. Impact of minimally invasive surgery on the treatment of esophageal achalasia::a decade of change. J Am Coll Surg 2003;196:698–705.PubMedCrossRefGoogle Scholar
Boeckxstaens GE, Annese V, des Varannes SB et al. Pneumatic dilation versus laparoscopic Heller's myotomy for idiopathic achalasia. N Engl J Med 2011;364:1807–1816.PubMedCrossRefGoogle Scholar
Pandolfino JE, Kwiatek MA, Nealis T et al. Achalasia: a new clinically relevant classification by high-resolution manometry. Gastroenterology 2008;135:1526–1533PubMedCrossRefGoogle Scholar
Inoue H, Minami H, Kobayashi Y et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy 2010;42:265–271PubMedCrossRefGoogle Scholar