Heller myotomy is superior to dilatation for the treatment of early achalasia

Marco Anselmino, Galen Perdikis, Ronald A. Hinder, Paul V. Polishuk, Paul Wilson, John D. Terry, Stephen J. Lanspa

Research output: Contribution to journalArticlepeer-review

63 Scopus citations


Objectives: To study the pretreatment characteristics that predispose a patient to rupture and to compare the outcome after dilatation with the outcome after surgical myotomy. Design: A survey of all patients treated for achalasia at the Creighton University Medical Center, Omaha, Neb, during a 16-year period. Clinical examination and testing of consenting patients at 12 months and longer after treatment. Setting: Tertiary referral center. Patients: Of the 61 patients, 55 were treated with dilatation. Esophageal rupture developed in 8 patients (14.5%) with achalasia after pneumatic dilataion; these patients underwent surgery for the rupture. Dilatation failed in 8 other patients; these patients underwent a surgical myotomy. Six patients underwent a primary surgical myotomy. Main Outcome Measures: Duration of symptoms, weigth loss, lower esophageal sphincter resting pressure and relaxation, amplitude and quality of distal esophageal contractions (assessed by manometry), 24-hour esophageal pH, and maximal esophageal diameter (assessed by barium swallow examination). Results: Surgical myotomy at a mean (±SEM) of 44.9±18.6 months alleviated dysphagia in 13 (93%) of the 14 patients compared with only 12 (39%) of the 31 patients after dilation at a mean (±SEM) of 55.0±11.7 months (P

Original languageEnglish (US)
Pages (from-to)233-240
Number of pages8
JournalArchives of Surgery
Issue number3
StatePublished - Jan 1 1997

All Science Journal Classification (ASJC) codes

  • Surgery


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