[The role of the intraoperative manometry in the esophageal achalasia surgical treatment].
BACKGROUND
The authors report their experience about the intraoperative manometry in the achalasia surgical treatment.


METHODS
We have considered 239 patients with achalasia observed from 1994 to 2006; only 79 continued the path diagnostic therapeutic and 31 underwent Heller longitudinal miotomy, with Dor anti-reflux plastic in 25 patients and in 6 Nissen anti-reflux plastic. In 24 we performed the intraoperative manometry (MI) recording the high pressure areas.


RESULTS
The patients underwent Heller's procedure with manometric check of the gastric muscular fibre sectioned areas reported the disappearance of the dysphagia. Three of the operated ones without using the MI complained about the persistence of mild dysphagia and it did not depend from the antireflux surgical procedure used.


CONCLUSIONS
Our findings confirm that the extramucosal miotomy is the treatment of choice for the achalasia and suggest that by MI a complete miotomy is allowed mostly on the gastric side where the muscular fibres get an important role in the maintenance of the high pressure areas.
Università degli Studi di Palermo, Policlinico Paolo Giaccone, Dipartimento di Discipline Chirurgiche ed Oncologiche, Cattedra di Chirurgia Generale e Fisiopatologia chirurgica.
S
S
Bonventre
M
M
Frazzetta
M
M
Lucania
F
F
Frazzetta
A S
AS
Sciortino
D
D
Sammartano
G
G
Vetri
G
G
Di Gesù
D004931:Esophageal Achalasia / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008365:Manometry
Il ruolo della manometria intraoperatoria nel trattamento chirurgico dell'acalasia esofagea.