Laparoscopic Heller myotomy for achalasia: a review of the controversies.
Achalasia is a rare primary motility disorder of the esophagus with a United States prevalence of less than 0.001%. Laparoscopic modified Heller myotomy has become the standard of care for palliation of this incurable but benign disease. The role of a fundoplication with the myotomy continues to be controversial. This report summarizes the current laparoscopic management of achalasia with a review of the medical literature on the outcome of combining a fundoplication with a laparoscopic myotomy. The optimal length of myotomy as suggested in the literature is also summarized. To complete the goal, peer-reviewed publications were identified in PubMed by search terms achalasia, myotomy, fundoplication, Nissen, Dor, and Toupet.
Litle
Virginia R
VR
Division of Thoracic Surgery, Department of Cardiothoracic Surgery, The Mount Sinai Medical Center, New York, New York 10029-6574, USA. virginia.litle@mountsinai.org
D004931:Esophageal Achalasia / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D009130:Muscle, Smooth / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome