title: Laparoscopic Heller myotomy as the gold standard for treatment of achalasia.
abstract: BACKGROUND
  The recent introductions of novel methods for the treatment of achalasia as well as ongoing controversies about the merits of surgical and endoscopic treatment options have created controversy in identifying the optimal treatment for this condition. This lack of clarity prompted this review of 206 consecutive patients treated with a laparoscopic Heller (LH) myotomy over a 16-year period.
  
  
  METHODS
  A retrospective review of a prospectively collected database was performed of 206 consecutive LH performed by a single surgeon.
  
  
  RESULTS
  In this cohort, 58 % of patients had undergone a prior therapeutic intervention. Over 90 % of patients had relief of dysphagia post-operatively. There was one intraoperative esophageal perforation. There were no mortalities. Only 4/206 patients sustained complications that required either post-op therapeutic intervention or delayed hospital discharge.
  
  
  CONCLUSIONS
  This paper outlines an operative technique that has yielded outstanding results and may be used as a benchmark against which other therapies can be judged.
authors.affiliation: Department of Surgery, Massachusetts General Hospital, WACC-460 15 Parkman St, Boston, MA, 02114-3117, USA, peter-nau@uiowa.edu.
authors.forename: Peter
authors.initials: P
authors.lastname: Nau
authors.forename: David
authors.initials: D
authors.lastname: Rattner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D013505:Digestive System Surgical Procedures / Q000379:methods / Q000592:standards*; D004931:Esophageal Achalasia / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult