LAUSR

Laparoscopic Heller myotomy and fundoplication is considered today the treatment of choice for achalasia. The primary objective of this study was to review our experience in minimally invasive myotomy as primary therapy for the treatment of esophageal achalasia. A retrospective analysis of a prospective database was made in which 253 clinical histories of patients diagnosed with EA were reviewed. These patients underwent primary laparoscopic Heller´s myotomy from January 2010 to December 2016. Duration of symptoms, previous endoscopic treatments, degree of dilation of the esophagus and clinical progress were some of the variables assessed. Postoperative assessment was obtained through the attending physicians’ consultations and recorded in the clinical history at six months and one year. Vantrappen and Helleman´s classification was used. 253 Heller´s myotomies were performed by laparoscopic approach. The mean age of the patients was 47 years (range, 16 to 86). Duration of the symptoms was between 7 and 360 months, with an average of 54 months. The mean operative time was 100 minutes (range 90–210). Average hospital stay was one day. There were no conversions and no mortalities. Four patients (1,1%) underwent redo surgery. The clinical progress was excellent in 98,5% of patients. Laparoscopic myotomy is the first line of treatment of esophageal achalasia. In this series of patients, laparoscopic Heller´s myotomy was an effective and safe treatment for esophageal achalasia. All authors have declared no conflicts of interest.