Forceful balloon dilation: an outpatient procedure for achalasia

One-year follow-up after laparoscopic Heller-Dor operation for esophageal achalasia

“…Large and historical series of patients who received pneumatic dilatation or myotomy have been retrospectively compared, and in association with the only one prospective controlled trial performed to compare both procedures confirmed that results are better in terms of both controlling dysphagia and complications after surgery, with a very low risk of postoperative gastroesophageal reflux [8,11,17]. Nevertheless, some authors argue that postoperative pain due to the surgical incision, together with high costs of the surgical procedure and of the lengthy hospitalization, make pneumatic dilatation more suitable than definitive surgical treatment [4,21]. But minor patient discomfort and a shorter hospital stay and convalescence are now ensured by minimally invasive techniques which allow for myotomy to be completed using laparoscopy or thoracoscopy [3,14,15,18].…”

Review article: the management of achalasia – a comparison of different treatment modalities1

“…34 The Rigiflex (Microvasive) balloon dilator is the most commonly used dilator and has been demonstrated to be effective. Early data included 24 patients treated initially with a 30-mm Rigiflex balloon dilatation and showed resolution of symptoms in 70% and a 60% decrease in LES pressure.…”

Achalasia: What’s New in Diagnosis and Treatment?

“…It is impossible to predict which patient will perforate, but tachycardia, prolonged chest pain (>4 h) after dilatation and/or fever are highly suggestive of a perforation [192,204]. Free perforation into the mediastinum, pleural or peritoneal space requires surgery, whereas contained perforations beyond the muscular wall can be treated medically with intravenous antibiotics, parenteral hyperali mentation and nasogastric suction for 1-2 weeks [205][206][207][208].…”