Endoscopic Balloon Dilation Versus Laparoscopic Heller Myotomy: Comparing Two Treatment Methods for Achalasia

The most established treatments for achalasia are endoscopic balloon dilation (EBD) and laparoscopic Heller myotomy (LHM). This study aimed to compare the clinical outcomes and long-term quality of life of patients treated with EBD or LHM. Our study was a cross-sectional study on patients with idiopathic achalasia referred to the manometry center of Khorshid Hospital from 2018 to 2020. First, clinical and demographic data of patients were asked and supplemented by HRQOL (health-related quality of life questionnaire) and Eckardt questionnaires. In a 1-year follow-up, patients were called again and asked about the treatment choice (EBD or LHM), and clinical symptom improvement, quality of life, the asymptomatic period after treatment, and failure of the procedure were assessed. Of a total of 100 patients, 63 (63%) were men, and the mean age was 43.48 SD 8.76. The EBD procedure was conducted for 43 (43%). After 1 year of follow-up, the mean delta Eckardt score and the mean relative effect for Eckardt were significantly better for the LHM group. However, the mean delta HRQOL score and the mean relative effect for HRQOL for both groups were not significantly different. The total number of treatment failures was 9 (9%), which was significantly higher in the EBD group. The mean asymptomatic period after the procedure was significantly higher in the LHM group. Both EBD and LHM methods have a noticeable effect on symptom improvement, but LHM had better results in symptom improvement, treatment failure, and asymptomatic period time after the procedure.

Automated summary

This study compared the effects of endoscopic balloon dilation (EBD) and laparoscopic Heller myotomy (LHM) on the asymptomatic period, symptom improvement, and treatment failure in patients with achalasia. The results showed that LHM had better outcomes in terms of symptom improvement, treatment failure, and the duration of the asymptomatic period after the procedure.