For achalasia: which is better: dilation or myotomy?

Myotomy. It has higher success rates (~90%) and is longer lasting.
Myotomy. With the ability to perform a myotomy laparoscopically, there is really no question that if you are healthy enough to have surgery then a myotomy is the way to go. Dilations and Botox injections work for a while, but need to be repeated. Whereas with surgery very rarely will a repeat operation be required.
Usually myotomy. Very patient has different goals an tolerance or procedures. Dilation usually requires at least two sessions, and is 85% effective at 5 years, and myotomy is 90-95% effective at 5 years after a single treatment, but is more invasive. There is a new way to do myotomy called per oral endoscopic myotomy (poem). This method is being done in san diego, portland, chicago, cleveland, and springfield, ma.

Related Questions

How successful is a laparoscopic myotomy and fundoplication for achalasia?

Very. If you truly have achalasia a laparoscopic myotomy can provide improvement in your symptoms almost instantly. The long term satisfaction from the surgery is also very good. Read more...
Very. Laparoscopic myotomy and anterior or dor fundoplication is the most common surgical procedure, and has 85-95% success rate at 5 years. There are some centers in the us that perform myotomy without abdominal incisions via an endoscopic approach called per oral endoscopic myotomy (poem). Read more...

Achalasia patient. I'm told that I need the heller myotomy surgery, but I'm hearing about multiple people getting a 2nd or 3rd hm. Why is this?

Achalasia. Aloha. Surgery for achalasia can be tricky. Sometimes the myotomy is inadequate requires a revision. Sometimes the workup for achalasia is incomplete and the heller might not be the right operation. Sometimes the esophageal dysmotility is so bad that a heller isn't enough and an esophagectomy is required. Lots of possibilities. You need high res manometry & also go to an experienced surgeon &. Read more...
Complex. There are multiple reasons a myotomy may fail, including not a long enough myotomy. Since the esophagus is never normal, there may always be some symptoms. Per oral endoscopic myotomy - poem is available in japan, china, and increasingly so at several centers in the us. Hope this helps! Read more...