Arvanitakis C
Am J Dig Dis. 1975 Sep;20(9):841-6. doi: 10.1007/BF01070952.
56 patients with achalasia of the esophagus were reviewed in a retrospective study to compare the results of a forceful pneumatic dilation with those of a Heller esophagomyotomy. 22 of 33 patients treated with forceful dilation (67%), showed relief of dysphagia and reduction in the average esophageal diameter by barium swallow during the follow-up period (mean = 6.5 years). In 2 patients (6%), forceful dilation was complicated by esophageal perforation, promptly diagnosed, and successfully treated at surgery in both patients. 21 out of 23 patients who underwent esophagomyotomy (91%) showed permanent relief of symptoms and improvement by endoscopic and radiographic criteria. There were no significant postoperative complications during the follow-up period ranging between 1.5 and 10.0 years. The results of this study indicate that esophagomyotomy constitutes a more effective therapeutic modality than forceful dilation (P less than 0.05). Although esophageal dilation has a place in the treatment of early achalasia, esophagomyotomy appears to be a safer and a more successful form of treatment, of particular value in advanced esophageal disease and in those instances where pneumatic dilation fails to result in immediate clinical improvement.
对56例贲门失弛缓症患者进行了一项回顾性研究，以比较强力气囊扩张术与赫勒食管肌层切开术的治疗效果。33例接受强力扩张术的患者中，22例（67%）在随访期间（平均6.5年）吞咽困难症状缓解，吞钡检查显示食管平均直径缩小。2例患者（6%）强力扩张术并发食管穿孔，均及时诊断，并通过手术成功治疗。23例接受食管肌层切开术的患者中，21例（91%）症状得到永久性缓解，内镜和影像学检查显示病情改善。在1.5至10.0年的随访期间，无明显术后并发症。本研究结果表明，食管肌层切开术是一种比强力扩张术更有效的治疗方式（P<0.05）。尽管食管扩张术在早期贲门失弛缓症的治疗中有一定作用，但食管肌层切开术似乎是一种更安全、更成功的治疗方式，在晚期食管疾病以及气囊扩张术未能立即带来临床改善的情况下具有特殊价值。
