Abstract
Laparoscopic Heller’s myotomy is the most common surgical procedure to treat achalasia. It is the most accepted therapy for non-advanced stages of the disease. In the setting of advanced disease with marked esophageal dilatation or sigmoid-shaped esophagus the ideal surgical procedure is debatable. Esophagectomy is believed by several authors to be the operation of choice in these cases. Others; however, opt for less invasive alternatives. Laparoscopic Heller’s myotomy has been shown to be a safe and resourceful alternative in end-stage achalasia as well.
Highlights
Achalasia is a rare neurodegenerative primary esophageal motor disorder characterized by abnormal lower esophageal sphincter relaxation and aperistalsis[1]
In Brazil, 4 different stages of esophageal dilatation are considered[8] and end-stage disease is defined by diameterover 10 cm[9]
Recurrent dysphagia after Laparoscopic Heller’s myotomy (LHM) may be treated by endoscopic dilatation[50], peroral endoscopic myotomy (POEM)[50,51], redo LHM[50], cardioplasty with or without gastrectomy[33,34,36], or esophagectomy[10,50]
Summary
One size fits all: laparoscopic Heller’s myotomy for the treatment of achalasia irrespective of the degree of dilatation. Leonardo de Mello Del Grande, Fernando A. How to cite this article: Del Grande LM, Herbella FAM, Patti MG, Schlottmann F. Article history: Received: 15 Jun 2017 Accepted: 30 Aug 2017 Published: 30 Sep 2017
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