AIM:To determine the best method out of the three typesof interventional procedure for achalasia based on a long-term follow-up.METHODS:The study cohort was comprised of 133 patientsof achalasia.Among them,60 patients were treated underfluoroscopy with pneumatic dilation (group A),8 patientswith permanent uncovered or antireflux covered metal stentdilation (group B),and 65 patients with temporary partiallycovered metal stent dilation (group C).RESULTS:One hundred and thirty dilations were performedon the 60 patients of group A (mean 2.2 times per case).The mean diameter of the strictured cardia was 3.3±2.1 mmbefore dilation and 10.6±3.8 mm after dilation.The meandysphagia score was 2.7±1.4 before dilation and 0.9±0.3after dilation.Complications in group A were chest pain(n=30),reflux (n=16),and bleeding (n=6).Thirty-sixpatients (60%) in group A exhibited dysphagia relapseduring a 12-month follow-up,and 45 patients (90%) out of50 exhibited dysphagia relapse during a 36-month follow-up.Five uncovered and 3 antireflux covered expandablemetal stents were permanently placed in the 8 patients ofgroup B.The mean diameter of the strictured cardia was3.4±1.9 mm before dilation and 19.5±1.1 mm after dilation.The mean dysphagia score was 2.6±1.3 before dilation and0.4±0.1 after dilation.Complications in group B were chestpain (n=6),reflux (n=5),bleeding (n=3),and hyperplasiaof granulation tissue (n=3).Four patients (50%) in groupB exhibited dysphagia relapse during a 12-month follow-up,and 2 case (66.7%) out of 3 patients exhibited dysphagiarelapse during a 36-month follow-up.Sixty-five partiallycovered expandable metal stents were temporarily placedin the 65 patients of group C and withdrawn after 3-7 daysvia gastroscopy.The mean diameter of the strictured cardiawas 3.3±2.3 mm before dilation and 18.9±3.5 mm afterdilation.The mean dysphagia score was 2.4±1.3 beforedilation and 0.5±0.2 after dilation.Complications in group Cwere chest pain (n=26),reflux (n=13),and bleeding (n=8).6 patients (9.2%) out of 65 exhibited dysphagia relapse during a 12-month follow-up,and 8 patients (14.5%) outof 55 exhibited dysphagia relapse during a 36-month follow-up.All the stents were inserted and withdrawn successfully.The follow-up in groups A-C lasted 12-96 months.CONCLUSION:Temporary partially covered metal stentdilation is one of the best methods with interventionalprocedure for achalasia in terms of long-term follow-up. AIM: To determine the best method out of the three types of interventional procedure for achalasia based on a long-term follow-up. METHODS: The study cohort was made of 133 patients of achalasia. Amm them, 60 patients were treated under fluoroscopy with pneumatic dilation ( group A), 8 patients with permanent uncovered or antireflux covered metal stentdilation (group B), and 65 patients with temporary partially covered metal stent dilation (group C) .RESULTS: One hundred and thirty dilations were performed on the 60 patients of group A (mean 2.2 times per case). The mean diameter of the strictured cardia was 3.3 ± 2.1 mmbefore dilation and 10.6 ± 3.8 mm after dilation. The meandysphagia score was 2.7 ± 1.4 before dilation and 0.9 ± 0.3 after dilation. Complications in group A were chest pain ( Thirty-six patients (60%) in group A showed dysphagia relapsed a 12-month follow-up, and 45 patients (90%) out of 50 exhibited dysphagia relapse during a 36-month follow- up.Five uncovered and 3 antireflux covered expandablemetal stents were permanently placed in the 8 patients of group B. The mean diameter of the strictured cardia was 3.4 ± 1.9 mm before dilation and 19.5 ± 1.1 mm after dilation.The mean dysphagia score was 2.6 ± 1.3 before dilation and 0.4 ± 0.1 after dilation. Complications in group B were chest pain (n = 6), reflux (n = 3), and hyperplasia of granulation tissue (n = 3) 50%) in group B exhibiting dysphagia relapse during a 12-month follow-up, and 2 cases (66.7%) out of 3 patients exhibiting dysphagiarelapse during a 36-month follow-up. Sixty-five partially uncovered expandable metal stents were temporarily placed in the 65 patients of group C and withdrawn after 3-7 daysvia gastroscopy. The mean diameter of the strictured cardiawas 3.3 ± 2.3 mm before dilation and 18.9 ± 3.5 mm afterdilation. The mean dysphagia score was 2.4 ± 1.3 beforedilation and 0.5 ± 0.2 after dilation. Complications in group Cwere chest pain (n = 26), reflux (n = 13), and bleeding (n= 8) .6 patients (9.2%) out of 65 exhib dysphagia relapse during a 12-month follow-up, and 8 patients (14.5%) outof 55 exhibiting dysphagia relapse during a 36-month follow-up. All the stents were inserted and withdrawn successfully. The follow-up in groups AC lasted 12-96 months. CONCLUSION: Temporary partially covered metal stentdilation is one of the best methods with interventional procedures for achalasia in terms of long-term follow-up.