title: Heller myotomy and laparoscopic fundoplication in achalasia. A retrospective experience.
abstract: BACKGROUND
  Laparoscopic myotomy associated with fundoplication is a useful therapeutic resource for the treatment of achalasia. The aim of the study was to analyze the outcomes of the surgical treatment of achalasia in a group of patients treated at the Hospital Naval de la Secretaría de Marina and at the Hospital Español in Veracruz during a 6-year period.
  
  
  METHODS
  Eleven patients were submitted to myotomy and fundoplication. Variables analyzed were age, gender, symptom duration, surgical complications, surgical time, day/stay, and postoperative morbidity.
  
  
  RESULTS
  Mean age was 41.7 years ± 7.69 years; 63.64% of the patients were male and 36.36% were female. Average time from symptom onset was 2.5 ± 1.38 years. All patients had received previous unsuccessful medical and endoscopic treatment. Diagnosis was confirmed by esophagogram, endoscopy and manometry. All patients underwent Heller myotomy and fundoplication. Operative time was 140.4 ± 26.2 min. Average days/stay was 3.7 ± 1.4 days. Postoperative course was satisfactory in all patients and there was no perioperative mortality. Average follow-up was 3.8 ± 2.3 years.
  
  
  CONCLUSIONS
  In our group, laparoscopic myotomy with fundoplication was a safe procedure offering excellent results comparable with those published in the literature. There is controversy about the type of fundoplication; therefore, the choice is at the discretion of the surgeon.
authors.affiliation: Departamento de Gastroenterología, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Mexico. froesch@uv.mx
authors.forename: Federico
authors.initials: F
authors.lastname: Roesch-Dietlen
authors.forename: Alfonso Gerardo
authors.initials: AG
authors.lastname: Pérez-Morales
authors.forename: Julio
authors.initials: J
authors.lastname: Ballinas-Bustamante
authors.forename: Silvia
authors.initials: S
authors.lastname: Martínez-Fernández
authors.forename: José María
authors.initials: JM
authors.lastname: Remes-Troche
authors.forename: Victoria Alejandra
authors.initials: VA
authors.lastname: Jiménez-García
mesh_terms: D000328:Adult; D004931:Esophageal Achalasia / Q000000981:diagnostic imaging / Q000601:surgery*; D049630:Esophageal Sphincter, Lower / Q000601:surgery*; D004945:Esophagoscopy; D005260:Female; D018662:Fundoplication / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome