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

P Dell'abate, P Soliani, M Berni Canani, P Piccolo, R Sabag, E Foggi
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Abstract

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.

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食管贲门失弛缓症的保守内镜治疗。我们的经验)。
作者报告了他们在1992年1月至1995年8月期间在帕尔马大学普通胸外科和血管外科研究所消化内窥镜实验室对18例贲门失弛缓症患者进行气动扩张内窥镜治疗的经验。男性10例,女性8例,年龄23 ~ 79岁,平均年龄48岁。最常见的症状是吞咽困难,所有患者都进行了放射学和压力测量学研究,证实了临床和内镜诊断。所有患者均在内镜控制下进行了气动扩张。总共进行了36次扩张,未出现与该方法相关的并发症。最长30个月的随访证实89%的病例预后良好。3例有胃食管反流症状,但经药物治疗成功。作者的结论是,气动扩张是贲门失弛缓症的首选治疗方法,只有对这种治疗有抵抗力的病例才会选择手术方法。
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