Endoscopic techniques in the diagnosis and treatment of achalasia cardii

Achalasia is a disease from group of the neuromuscular esophageal pathology and occupying the fourth place in the structure of surgical diseases of the esophagus. In a base of achalasia is a persistent lack of relaxation of the lower esophageal sphincter and esophageal motility discoordination. The article describes the historical aspects, clinical symptoms, diagnosis and modern approaches to the treatment of patients with this pathology. 37 cases of achalasia I-IV stage are analyzed in the article. Based on our own experience and results it was found that starting treatment achalasia is necessary with minimally invasive techniques. The most effective way is endoscopic balloon dilation, was performed in 33 patients and in 31 (93.9%) proved to be successful. For remission must be fulfilled 2-3 courses of balloon dilation, including 1-3 sessions. In case of failure of endoscopic treatment laparoscopy (Heller with fundoplication) was performed. And in patients with stage IV operation of choice was used subtotal resection of the esophagus with simultaneous plasty gastric tube.