RECURRENT ACHALASIA IN A GERIATRIC PATIENT - A THERAPEUTIC CHALLENGE
Achalasia is an esophageal motility dysfunction characterized by the lack of peristalsis and insufficient relaxation of the lower esophageal sphincter on swallowing. This study aims to analyze the therapeutic options currently used in the treatment of recurrent achalasia and to compare their effectiveness in the geriatric patient. Extreme age poses problems with therapy, so the present paper seeks to demonstrate that the surgical approach, although usually avoided or delayed in this age group, due to the additional risks involved, may be the elective therapy for the treatment of recurrent achalasia in the elderly. Following a rigorous search, 47 studies were selected regarding the methods of treatment and the evolution over time of the symptoms of achalasia, excluding case presentations related to the subject. The treatment of geriatric patients should be based only on the physiological status not age, and laparoscopic Heller myotomy can be the first treatment option, noting that it is very important to consider the manometric subtype, which provides information about the prognosis and the most appropriate form of treatment.
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