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Abstract

Esophageal achalasia is a primary esophageal motor disorder characterized by aperistalsis and failure in lower esophageal sphincter (LES) relaxation [1]. Treatment aim is to decrease LES pressure and integrated relaxation pressure (IRP), in order to improve symptoms and quality of life [2,3]. Laparoscopic Heller Myotomy (LHM) and Peroral endoscopic myotomy (POEM) are considered the gold standard of treatment [4][5][6]; however, safety is compromised in some populations, such as in elderly patients (adverse events of 2 % to 11.5 % in LHM and 5 % to 7.8 % for POEM [7][8][9]), representing high-risk procedures for them. Alternative treatments include pneumatic dilation (PD) (73 %-88 % early and mid-term efficacy, but a median of 1.9 % perforation rate [4][5][6][7][8][9][10]) and botulinum toxin injection (BTI) (initial 87 % to 92 %, but 22 % to 31 % mid-term efficacy Safety and efficacy of biodegradable stents in octogenarian patients with esophageal achalasia