Six years of experience in laparoscopic surgery of esophageal achalasia.
BACKGROUND
We show the experience of 6 years in laparoscopic surgical therapy of esophageal achalasia, performing of the Heller-Dor or Heller-Toupet operation, with particular regard to the technical aspect.


METHODS
One hundred and ten laparoscopic interventions were done between November 1995 and December 2001. We studied operative time in hiatus approach, esophagocardiomyotomy, transoperative endoscopy, and anti-reflux procedure. We also analyzed the relation between complications and clinical evolution of disease with clinical stage.


RESULTS
The mean surgical time of the intervention is 138 min, and it is significantly increased by transoperative endoscopic control; conversion to open surgery was not necessary. Clinical results are classified as excellent in 103 patients. Morbidity was 6%.


CONCLUSIONS
This surgical procedure is a first line in the treatment of esophageal achalasia. It is necessary to have special care in early diagnostic cases to avoid electrosurgical injury.
Fernández
A F
AF
Centro de Cirugía Endoscópica, Hospital Universitario General Calixto García, Ave de la Universidad y calle J. La Habana, Cuba CP: 10 400. arnulfo@cce.sid.cu
Martínez
M A
MA
Ruiz
J
J
Torres
R
R
Faife
B
B
Torres
J R
JR
Escoto
C M
CM
D000293:Adolescent; D000328:Adult; D000368:Aged; D003462:Cuba / Q000453:epidemiology; D004931:Esophageal Achalasia / Q000601:surgery*; D004945:Esophagoscopy / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome