[Laparoscopic treatment of achalasia: analysis of results and reflections on the technique].
BACKGROUND
Heller myotomy using the laparoscopic approach is the best treatment that we can offer to patients with achalasia. On not acting on the cause of the disease, we can only alleviate the persistence of the symptoms, but not make them disappear.


OBJECTIVE
To analyse the results of our group in the treatment of achalasia by laparoscopy.


METHODS
The pre- and post-operative results are analysed of a series of 20 patients intervened prospectively by laparoscopy of achalasia during a period from May 2003 to April 2010. For this we used a modification of the grading scale of pre- and post-operative symptoms described by Velanovich for GER (a scale from 0-5). Data on the complications and the hospital stay were also collected.


RESULTS
A wide Heller myotomy was performed using a Dor type antireflux mechanism. There were no oesophageal perforations or complications during the surgery. Two (10%) patients had postoperative complications. The mean hospital stay was 3.11 ± 2.13 days. After a mean follow up of 55.8 ± 14.1 months, the symptoms studied had significantly decreased after the surgery. Only 3 (15%) patients had clinical symptoms of GER after surgery. Nineteen patients (95%) said they were satisfied with the operation.


CONCLUSIONS
The laparoscopic treatment of achalasia is a safe technique, reproducible and effective technique, which achieves very satisfactory control of the achalasia symptoms with a minimum of morbidity.
Servicio de Cirugía General, Hospital General d'Igualada, Igualada, Barcelona, España. 16255xfp@comb.es
Xavier
X
Feliu
Pere
P
Besora
Ramón
R
Clavería
Josep
J
Camps
David
D
Salazar
Xavier
X
Viñas
Josep M
JM
Abad
D000328:Adult; D000368:Aged; D004931:Esophageal Achalasia / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult