The surgical approach to oesophageal achalasia

G. Mattioli, A. Cagnazzo, A. Barabino, P. E. Caffarena, G. Ivani, V. Jasonni

Research output: Contribution to journalArticle

Abstract

The term 'oesophageal achalasia' describes a neuropathic disorder characterized by abnormal motility of the oesophagus and incomplete or absent relaxation of the lower oesophageal sphincter. In these patients with 'paroxysmal' dysphagia, barium swallow and manometric study confirm the diagnosis. In our opinion, the treatment of choice is extramucosal cardiomyotomy (Heller) which should be followed by gastric fundoplication in order to protect the mucosa and prevent gastrooesophageal reflux. We present our experience in the laparoscopic approach to Heller cardiomyotomy in children. An anterior 180°hemi-fundoplication, according to Dor technique, is performed suturing the left and right oesophageal muscular margin to the gastric wrap. A manometric examination is mandatory in order to detect the complete incision of the lower oesophageal sphincter and to confirm the creation of the new-high pressure zone. This preliminary experience confirms that the laparoscopic approach can be used for the treatment of oesophageal achalasia also in children.

Original languageEnglish
Pages (from-to)323-327
Number of pages5
JournalEuropean Journal of Pediatric Surgery
Volume7
Issue number6
Publication statusPublished - Dec 1997

Keywords

  • Laparoscopic surgery
  • Oesophageal achalasia
  • Oesophageal manometry
  • Paediatric surgery

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Mattioli, G., Cagnazzo, A., Barabino, A., Caffarena, P. E., Ivani, G., & Jasonni, V. (1997). The surgical approach to oesophageal achalasia. European Journal of Pediatric Surgery, 7(6), 323-327.