Pneumatic Dilation vs. Laparoscopic Heller Myotomy for Achalasia

The perforation rate was lower for PD than LHM when experienced gastroenterologists used a 30 mm Rigiflex balloon dilator.

Recent data suggest comparable efficacy of pneumatic dilation (PD) and laparoscopic Heller myotomy (LHM) in treating patients with achalasia. So which is best? The current study reviews the major complication rates of PD and LHM in a high-volume center of excellence for esophageal disease treatment. Additionally, the authors conducted a systematic review of the literature on PD (with use of Rigiflex dilators only) and related esophageal perforation.

During a 12-year period, 463 patients with achalasia underwent 567 PD or LHM procedures. Most PDs (78%) were performed with a 30 mm Rigiflex balloon dilator and were effective in 91% of patients — 64% after one procedure and an additional 27% after two procedures. Patients who did not improve aft…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors