title: Laparoscopic Heller myotomy and fundoplication in patients with end-stage achalasia.
abstract: Achalasia may present in a non-advanced or advanced (end stage) stage. The latter is characterized by massive esophageal dilatation and/or the loss of the esophageal straight axis (sigmoid-shaped esophagus). The treatment for non-advanced cases of achalasia is well defined while the therapy for end-stage disease is still debatable. Laparoscopic Heller's myotomy is an option in patients with end-stage achalasia. Dysphagia is relieved in a significant number of patients, it is a simpler operation to be used in frail patients, and it does not preclude a latter esophagectomy if necessary.
authors.affiliation: Department of Surgery, Escola Paulista de Medicina, Federal University of São Paulo, Rua Diogo de Faria 1087 cj 301, São Paulo, SP, 04037-003, Brazil, herbella.dcir@epm.br.
authors.forename: Fernando A M
authors.initials: FA
authors.lastname: Herbella
authors.forename: Marco G
authors.initials: MG
authors.lastname: Patti
mesh_terms: D004931:Esophageal Achalasia / Q000000981:diagnostic imaging / Q000601:surgery*; D049630:Esophageal Sphincter, Lower / Q000601:surgery*; D016629:Esophagectomy; D018662:Fundoplication; D006801:Humans; D010535:Laparoscopy; D011859:Radiography; D012720:Severity of Illness Index