CURRENT RESULTS OF SURGERY FOR ACHALASIA OF THE CARDIA

Several treatment options are available in the management of achalasia of the cardia. Of a recent series of 14 children, 12 were treated by a modified Heller's myotomy combined with a floppy Nissen fundoplicati on. Symptoms were dramatically improved in nine during a mean follow u p period of 3.9 years. Recurrent oesophageal pain was the most resista nt symptom and continued to be moderately severe in three patients, tw o of whom obtained temporary relief by oesophageal balloon dilatation. Two patients treated by pneumatic dilatation alone have residual symp toms. These results support a primary surgical approach to the managem ent of achalasia in children.