Laparoscopic treatment of recurrent dysphagia following transthoracic myotomy for achalasia.
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.
Robinson
Thomas N
TN
Department of Surgery, University of California, San Francisco, San Francisco, California.
Galvani
Carlos A
CA
Dutta
Sanjoy K
SK
Gorodner
Maria V
MV
Patti
Marco G
MG
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