LAPAROSCOPIC MANAGEMENT OF ACHALASIA

Eight patients with achalasia were treated using laparoscopic esophago myotomy and anterior (Dor) fundoplication. The procedures were done on patients with clinical, radiological, and manometric diagnoses of ach alasia. All procedures were completed laparoscopically. Seven (88%) of the patients were eating by the 3rd postoperative day. The average ho spital stay was 4.1 days (2-11 days); analgesic use was minimal. All m yotomies were complete, with no patient requiring reoperation or dilat ion. The only complication was a mucosal laceration in one patient; th is was successfully repaired laparoscopically. Follow-up from 8 to 20 months shows that swallowing is excellent in 88 per cent and good in 1 2 per cent of patients, and no patient requires antireflux medication. These results support minimally invasive surgical myotomy as the trea tment of choice for symptomatic achalasia.