Laparoscopic Heller Cardiomyotomy and Modified Dor Fundoplication for the Treatment of Achalasis of the Cardia

Objective: The aim of this study is to assess the feasibility and effectiveness of laparoscopic Heller s cardiomyotomy and modified Dor fundoplication for the treatment of achalasia of the cardia. Background: Achalasia of the cardia is the second most common motility disorder of the esophagus, with major impact on the life style of the affected patients. The goal of the treatment is to relieve functional out flow obstruction caused by loss of relaxation and compliance of LES. Endoscopic management is proved to be effective and safe modality. Patients and Methods: This is a retrospective study which was conducted on 10 patients with achalasia admitted in Kasr Al-Aini Surgical Department from January 2003 to January 2005. Preoperative work up included, history taking and proper physical examination with pre operative investigations includ-ing, upper endoscopy, barium swallow and esophaged ma-nometry. Patients were subjected to laparoscopic Heller s cardiomy-otomy and modified Dor Functoplication. All operative procedures were recorded and post operative results were tabulated and statistically analyzed to obtain significant data. Results: The procedure was completed laparoscopically in all patents and post operative follow up showed improvement of symptoms in all patients, without development of gastroe-sophageal reflux and with comparable results to previous studies, regarding percentages of symptoms improvement, post operative hospital stay and incidence of accepted minor complications.