title: Intra and post-operative complications of esophageal achalasia.
abstract: OBJECTIVE
  To evaluate and discuss all the potential complications affecting morbidity of patients treated with surgery for primary achalasia.
  
  
  METHODS
  A review of the available English literature published to date has been conducted. All articles reporting surgical experience in achalasia were examined and then were selected only those specifically inherent to the topic at issue.
  
  
  RESULTS
  Mucosal perforation is the main intra-operative complication while persistence or recurrence of the disease and gastro-esophageal reflux are those mostly affecting patients afterwards, even at long-term follow-up. A few other less common morbidities, as well as the technical considerations useful to minimize and manage each complication mentioned, are reported.
  
  
  CONCLUSIONS
  Minimally invasive surgery for achalasia consent to treat patients with a low rate of perioperative complications that can be managed with conservative approach in the majority of cases. Risk of esophageal cancer exists in these patients and remains although surgical therapy.
  
  
  CONCLUSIONS
  Laparoscopic Heller myotomy along with partial fundoplication is a safe and effective procedure that should be considered as the treatment of choice at first evaluation of achalasic patients rather than endoscopic techniques. Robotic technology may add further contribution in diminishing perioperative complications.
authors.forename: Luigi
authors.initials: L
authors.lastname: Pugliese
authors.forename: Andrea
authors.initials: A
authors.lastname: Peri
authors.forename: Francesco Paolo
authors.initials: FP
authors.lastname: Tinozzi
authors.forename: Sandro
authors.initials: S
authors.lastname: Zonta
authors.forename: Michele
authors.initials: M
authors.lastname: di Stefano
authors.forename: Federica
authors.initials: F
authors.lastname: Meloni
authors.forename: Andrea
authors.initials: A
authors.lastname: Pietrabissa
mesh_terms: D003680:Deglutition Disorders / Q000209:etiology; D004931:Esophageal Achalasia / Q000601:surgery*; D004939:Esophageal Perforation / Q000209:etiology; D005764:Gastroesophageal Reflux / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D012008:Recurrence