Is There a Role for Pneumatic Dilation in Primary Treatment of Achalasia? Con: PD Outcomes are Too Variable and Surgical Myotomy With POEM or Heller is Better

Abstract

Presently, we have 3 acceptable options for the treatment of achalasia: pneumatic dilation (PD), endoscopic myotomy (POEM), and laparoscopic myotomy (LM). Results from multicenter randomized trials demonstrate the superiority of myotomy over pneumatic dilation. While myotomy may be superior at relief of dysphagia, there may be circumstances where a thoughtful, individualized patient approach is more important.