title: Surgical laparoscopy with intraoperative manometry in the treatment of esophageal achalasia.
abstract: The aim of this study was to describe and evaluate the laparoscopic treatment of esophageal achalasia in nine patients over a 35-month period. Five trocars were used to perform a Heller's myotomy to completely eliminate the cardial high-pressure zone, under manometric control. Intraoperative manometry also was used to calibrate a pick degrees 360 Rossetti's antireflux wrap. A complete regression of symptoms was observed postoperatively in seven of nine patients (77.8%); in two patients (22.2%) a moderate dysphagia persisted, but it disappeared 3 and 6 months, respectively. Only one intraoperative complication (esophageal perforation, recognized and laparoscopically repaired) occurred. At the present follow-up of 18 +/- 5.34 months (range 6-35), no dysphagia or symptoms related to reflux have been observed. Laparoscopic treatment of esophageal achalasia is considered a safe and effective procedure, and the results of this procedure are comparable with those of the open technique. Advantages common to other laparoscopic techniques are emphasized.
authors.affiliation: III Department of General Surgery, University, Federico II, Naples, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Corcione
authors.forename: G
authors.initials: G
authors.lastname: Cristinzio
authors.forename: V
authors.initials: V
authors.lastname: Cimmino
authors.forename: S
authors.initials: S
authors.lastname: La Manna
authors.forename: M
authors.initials: M
authors.lastname: Maresca
authors.forename: G
authors.initials: G
authors.lastname: Titolo
authors.forename: G
authors.initials: G
authors.lastname: Califano
mesh_terms: D000293:Adolescent; D000328:Adult; D002299:Cardia / Q000601:surgery; D003680:Deglutition Disorders / Q000601:surgery; D004931:Esophageal Achalasia / Q000503:physiopathology / Q000601:surgery*; D004939:Esophageal Perforation / Q000209:etiology / Q000601:surgery; D004947:Esophagus / Q000293:injuries / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000601:surgery; D006801:Humans; D007430:Intraoperative Care; D007431:Intraoperative Complications; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008365:Manometry; D011312:Pressure; D012074:Remission Induction; D012449:Safety