Achalasia. Our Experience with the Laparoscopic Approach

Introduction: Authors present their experience of 30 case of achalasia treated with laparoscopic surgery. Methods: From January 2002 to 2007, 30 patients with achalasia were treated by a laparoscopic approach. Females were 20 and males were 10. Median age was 31.2. All of patients were studied with endoscopy and oesophagus manometry for the classification of achalasia. They were treated by Heller myotomy and fundoplication. Results: Pre-operative weight loss was 9 kg (range 3–16) with a mean duration of symptoms of 29 months (12–72). All patients had a laparoscopic Heller myotomy. Thirty percent received a partial anterior fundoplication according to Dor whereas the remaining seventy percent (21 of 30) had a complete fundoplication according to Nissen-Rossetti. The mean operative blood loss was 70 ml (30–150). All patients beared a NG tube for 3 days, and an X-ray contrast swallow was performed thereafter. Oral feeding started in case of negative X-ray control. One patient developed an oesophageal fistula. Followup ranged up to 4 years. Postoperatively, symptoms of dysphagia (to both solids and liquids), regurgitation, and cough were significantly reduced in all patients