Laparoscopic esophagomyotomy for achalasia. Preliminary results in 19 patients

Background: Laparoscopic esophagomyotomy is becoming a good alternative to pneumatic dilatation, injection of botulinic toxin or classical surgery, il l the treatment of achalasia. Aim: To report the results of laparoscopic es ophagomyotomy in patients with achalasia. Patients and methods: Nineteen pa tients with achalasia, nine women, aged 9 to 66 years old, operated between 1996 and 2001 are reported. Results: There was no surgical mortality. One patient had a subphrenic abscess elite to an unnoticed tear of they esophag eal mucosa. During surgery esophageal mucosa was perforated in 4 patients, that wets sutured ill three. One patient with all extensive tear of the muc osa required conversion to classical surgery. Patients there followed fort to 48 months. Radiological controls showed et significant increase in the d iameter of gastroesophageal function and a diameter reduction of the mid th ird esophageal segment. Lower esophageal pressure was significantly reduced . All patients experienced a weight increase and reduction of dysphagia. Co nclusions: Laparoscopic esophagomyotomy, is a safe alt effective therapeuti c alternative for achalasia.