LAPAROSCOPIC HELLER MYOTOMY WITHOUT ANTIR EFLUX PROCEDURE - ANALYSIS OF A SERIES OF 27 CASES

From November 1992 to June 1996, 27 laparoscopic Heller's myotomies wi thout antireflux procedure were performed. One mucosal tear occurred a nd was treated by open surgery. There was no mortality; one case of se psis with a good outcome was observed on the converted patient. The me an length of hospital stay was 5.5 days. The immediate functional resu lt was good in all cases. Postoperative esophageal manometry showed a significant reduction of the LES pressure, and postoperative pHmonitor ing showed one case of reflux. The long term functional result was goo d in 81% of cases, moderate in 19% (slight reflux in 3 cases and dysph agia in 2 cases). No failure and no reoperation occurred in this serie s. This procedure has been applied to all patients with achalasia sinc e December 1992.