A REVIEW OF 74 PATIENTS WITH OESOPHAGEAL ACHALASIA: THE RESULTS OF HELLERS CARDIOMYOTOMY, WITH AND WITHOUT NISSEN FUNDOPLICATION

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Abstract
A survey is presented of 74 patients with achalasia of the esophagus treated surgically. This survey spans a 27-yr period. Of 39 patients who underwent Heller''s operation, 23 (58.9%) had excellent results 6 mo. after operation and 17 (43.5%) still had excellent results more than 2 yr after operation. This group had a high recurrence of symptoms due to esophageal reflux (30.8%) and the development of strictures (20.5%) at the lower end of the esophagus. Thirty-five patients underwent Heller''s operation together with Nissen fundoplication. Thirty-two patients (91.4%) in this group had excellent results 6 mo. after operation, and 30 of these patients (85.7%) still had excellent results more than 2 yr after operation. Symptoms of esophageal reflux and subsequent esophageal stricture following Heller''s operation for achalasia can be considerably reduced, if not prevented, by Nissen fundoplication, a reflux-preventing procedure.