The purpose of this study was to analyze results of pneumatic dilatation due to esophageal achalasia at the Clinic of General Thoracic Surgery of Vilnius University.
Material and methods: During 25-year period (1973-1998) we have treated 133 achalasia patients. On 125 patients pneumatic dilatation was performed. One hundred five (84%) patients recovered fully. Single course of pneumatic dilatations was sufficient. Recurrence rate was 16% - 3 courses of pneumatic dilatations were performed on 2 (1.6%), 2 - on 18 (14.4%) patients. Complications. The major complication of pneumatic dilatation is esophageal perforation. Most series report its incidence at about 2%. In our study 2 cases (1.6%) of esophageal perforation occurred. Both patients were operated immediately. One (0.8%) died because of purulent complications.
Conclusion: Pneumatic dilatation is safe and effective method of treatment. In our opinion, it would be the best initial approach. If it failed, then myotomy would be treatment of choice.