BACKGROUND: Recently, investigators have reported the use of endoscopic myotomy in the treatment of @entity1318 . As with the open operation, considerable disagreement exists regarding the appropriate length of the myotomy and the need for a concomitant antireflux procedure. METHODS: @entity1 presenting with symptomatic @entity1318 between 1993 and 1997 were included in this prospective study. Preoperative studies included barium upper gastrointestinal study, endoscopy, and esophageal manometry. Laparoscopic myotomy was completed in all 20 @entity1 ; 18 had concomitant Toupet fundoplication. RESULTS: Operative times ranged from 95 to 345 minutes (mean 216). @entity190 ranged from 50 to 300 cc (mean 100 cc). There were 7 minor complications (5 @entity3137 repaired laparoscopically, 1 bile leak and 1 splenic capsular tear). Nine @entity1 began a liquid diet on the first day postoperatively; 19 were tolerating liquids by postoperative day 3. Hospital stay ranged from 2 to 20 days (mean 5). Eighteen @entity1 had complete relief of @entity1282 , with less than one reflux episode per month. One individual continues to have mild persistent solid food @entity1282 . Another @entity1 initially did well but subsequently developed mild recurrent @entity1282 and reflux. One @entity1 required laparoscopic take-down of the wrap because of recurrent @entity1282 and now has no problems swallowing, but does complain of mild reflux. Two other @entity1 also have mild reflux, 1 of whom did not undergo fundoplication. CONCLUSIONS: Laparoscopic Heller myotomy can be performed safely with excellent results in @entity1 with @entity1318 . Adding a partial fundoplication appears to help control postoperative symptoms of reflux. This procedure should be considered the procedure of choice in @entity1 with symptomatic @entity1318 .

Successful treatment of XXXX with laparoscopic Heller myotomy and Toupet fundoplication.

@entity1318 :: ('MESH:D004931', 'Disease') :: ['achalasia', 'esophageal achalasia'] @entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity190 :: ('MESH:D006473', 'Disease') :: ['Blood loss'] @entity1282 :: ('MESH:D003680', 'Disease') :: ['dysphagia'] @entity3137 :: ('MESH:D009059', 'Disease') :: ['mucosal injuries']
@entity1318 :: (MESH:D004931,Disease) :: ['esophageal achalasia']
