Long-term prognosis of patients with achalasia treated by cardial dilatation therapy.

The long-term prognosis of expanding bag dilatation therapy using a Matsuo pneumatic bag dilator was evaluated in 163 cases of esophageal achalasia treated by this method over the 26-year period from 1964 to 1989. In all these cases, one year or more had passed since therapy. Practically no correlation was found between the efficacy of the therapy and the grade of esophageal dilation prior to therapy, the previous history of symptomatic distress or the number of dilatations performed. The efficacy of expanding bag cardial dilatation was most obvious in the increase of body weight, 59 cases (36.2%) showing an increase of 1-5 kg and 48 cases (29.4%) showing an increase of 6-10 kg. The therapy was rated "highly effective" in 61 cases (37.4%) and "effective" in 60 cases (36.8%), i.e. it was effective in a total of 121 cases (74.2%). It was rated as being "ineffective" in 16 cases (9.8%) including 4.3% of cases in which an operation had been performed. This indicated that surgical operation of esophageal achalasia should be performed in those cases in which good long-term results were not obtained even after expanding bag dilatation therapy had been carried out several times.