Laparoscopic Heller myotomy with or without partial fundoplication: a matter of debate.
OBJECTIVE
To present our experience of laparoscopic Heller stretching myotomy followed by His angle reconstruction as surgical approach to esophageal achalasia.


METHODS
Thirty-two patients underwent laparoscopic Heller myotomy; an anterior partial fundoplication in 17, and angle of His reconstruction in 15 cases represented the antireflux procedure of choice.


RESULTS
There were no morbidity and mortality recorded in both anterior funduplication and angle of His reconstruction groups. No differences were detected in terms of recurrent dysphagia, p.o. reflux or medical therapy.


CONCLUSIONS
To reduce the incidence of recurrent achalasia after laparoscopic Heller myotomy, we believe that His' angle reconstruction is a safe and effective alternative to the anterior fundoplication.
Ramacciato
G
G
Facolta' di Medicina e Chirurgia, Universita' degli Studi di Roma La Sapienza, Ospedale Sant'Andrea, UOC Chirurgia D, Via di Grottarossa no. 1035-1037, 00189 Rome, Italy.
D'Angelo
F A
FA
Aurello
P
P
Del Gaudio
M
M
Varotti
G
G
Mercantini
P
P
Bellagamba
R
R
Ercolani
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D004931:Esophageal Achalasia / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D018662:Fundoplication; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000601:surgery*; D016896:Treatment Outcome