Six years of experience in laparoscopic surgery of esophageal achalasia

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Abstract
Background: We show the experience of 6 years in laparoscopic surgical therapy of esophageal achalasia, performing of the Heller–Dor or Heller–Toupet operation, with particular regard to the technical aspect. Methods: One hundred and ten laparoscopic interventions were done between November 1995 and December 2001. We studied operative time in hiatus approach, esophagocardiomyotomy, transoperative endoscopy, and anti-reflux procedure. We also analyzed the relation between complications and clinical evolution of disease with clinical stage. Results: The mean surgical time of the intervention is 138 min, and it is significantly increased by transoperative endoscopic control; conversion to open surgery was not necessary. Clinical results are classified as excellent in 103 patients. Morbidity was 6%. Conclusion: This surgical procedure is a first line in the treatment of esophageal achalasia. It is necessary to have special care in early diagnostic cases to avoid electrosurgical injury.

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