OBJECTIVES The impact of preoperative endoscopic therapy on the difficulty of laparoscopic Heller myotomy and the impact of the difficulty of the myotomy on long-term outcome has not been determined. This study was undertaken to determine whether preoperative therapy impacts the difficulty of laparoscopic Heller myotomy and whether preoperative therapy or difficulty of myotomy impacts long-term...

OBJECTIVE To review the current management of achalasia, and the controversies regarding the different treatment options. METHODS A review of the literature was performed. The key words used were esophageal achalasia, Heller myotomy, endoscopic balloon dilatation, laparoscopic Heller myotomy, and fundoplication. RESULTS Patients who fail medical therapy (e.g. pharmacologic therapy, botulinu...

Abstract Achalasia is a primary defect of esophageal motility unknown aetiology, characterised by peristaltic dysfunction the esophagus and impaired relaxation lower sphincter. The most common symptoms are dysphagia, regurgitation, weight loss, chest burning. There various treatment options for achalasia: botulinum toxin injections, pneumatic dilatation, Heller myotomy, peroral endoscopic myoto...

BACKGROUND Esophageal achalasia is the most common primary esophageal motor disorder. Laparoscopic Heller's myotomy combined with fundoplication represents the treatment of choice for this disease, achieving good results in about 90% of patients. However, about 10% of treated patients refer persistent or recurrent dysphagia. Many Authors showed that this failure rate is related to inadequate my...

BACKGROUND Achalasia is a relatively rare disorder with a variety of treatment options. Although laparoscopic Heller myotomy has become the surgical treatment of choice, little data exist on the overall quality of life of patients undergoing this technique versus standard open approaches. METHODS We prospectively evaluated all patients surgically treated for achalasia by a single surgeon. Lap...

HYPOTHESIS Operative manometry detects residual esophagogastric junction (EGJ) high pressure, ensuring complete myotomy. DESIGN Consecutive patients undergoing laparoscopic myotomy. SETTING Tertiary care academic medical center. PATIENTS From 1997 to 2003, 139 patients with achalasia underwent laparoscopic myotomy. INTERVENTIONS We assessed myotomy completeness by operative endoscopy an...

INTRODUCTION Two types of partial wrap are commonly performed in achalasia patients after Heller myotomy: the posterior 270° fundoplication (Toupet) and the anterior 180° fundoplication (Dor). The optimal type of fundoplication (posterior vs. anterior) is still debated. AIM To compare the long-term rates of dysphagia, reflux symptoms and patient satisfaction with current postoperative conditi...

BACKGROUND Laparoscopic Heller myotomy is the most effective therapy for achalasia. All case series have reported a minimum length of stay of more than 1 day. "True" day-case laparoscopic Heller myotomy has not been reported, so far. The aim of this study was to review our results with laparoscopic Heller myotomy with respect to the length of stay following the procedure. METHODS All patients...

AIM To evaluate the results of laparoscopic Heller myotomy in our group of patients. METHOD A retrospective clinical trial was carried out to evaluate the indication, technique and controversies of laparoscopic Heller myotomy in the achalasia treatment. The following symptoms were evaluated prior and after Heller myotomy: dysphagia, heartburn, nausea/vomiting after meal and asthma/coughing. T...

Aim : The aim of this study was to investigate whether intraoperative endoscopy (IOE) helps to identify the gastroesophageal junction, thereby reducing the frequency of suboptimal distal myotomy extent during laparoscopic Heller’s cardiomyotomy. To this end, laparoscopic and endoscopic criteria for localization of the cardia were compared. Then surgical outcomes in two consecutive groups of pat...