title: Laparoscopic treatment of recurrent dysphagia following transthoracic myotomy for achalasia.
abstract: BACKGROUND
  The choice of treatment of recurrent dysphagia following transthoracic myotomy is unclear. Often pneumatic dilatation is tried first, followed by esophagectomy in case of failure. We propose laparoscopic Heller myotomy as an alternative treatment for this group of patients.
  
  
  METHODS
  Three patients underwent laparoscopic Heller myotomy for the treatment of recurrent dysphagia following transthoracic myotomy. The patients had undergone an average of 7 pneumatic dilatations (range, 2 to 10) prior to referral for surgery, without resolution of their dysphagia.
  
  
  RESULTS
  All patients successfully underwent a laparoscopic myotomy on the right side of the esophagus with a Dor fundoplication. Good or excellent results were achieved in all patients. Average followup was 18 months.
  
  
  CONCLUSIONS
  Laparoscopic Heller myotomy is a very effective treatment for patients who experience recurrent dysphagia following a transthoracic myotomy.
authors.affiliation: Department of Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Robinson
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Galvani
authors.forename: Sanjoy K
authors.initials: SK
authors.lastname: Dutta
authors.forename: Maria V
authors.initials: MV
authors.lastname: Gorodner
authors.forename: Marco G
authors.initials: MG
authors.lastname: Patti
mesh_terms: D000328:Adult; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery*; D004931:Esophageal Achalasia / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012008:Recurrence