Laparoscopic Heller Cardiomyotomy with Dor’ Fundoplication Versus Pneumatic Dilatation for the Treatment of Achalasia

Aim of the Work: The aim of this study is to compare the long-term outcome of Pneumatic dilatation versus Laparoscopic Heller Cardiomyotomy with Dor’ fundoplication for the treatment of achalasia and to assess the advantages disadvantages of each modality.Patients and Methods: This is a retrospective study which was conducted on 20 patients suffering from achalasia of the cardia, patients were divided into two groups, group (A) included 10 patients and were managed by laparoscopic Heller cadiomyotomy with Dor’ fundoplication and group (B) included 10 patients managed by pneumatic dilatation.Results and Conclusion: Both modalities proved to be safe, effective and technically feasible. Short and long-term outcomes showed a slight superior results for laparoscopic Heller’s esophagocardiomyotomy with Dor’s fundoplication over Pneumatic dilatation, however pneumatic dilatation is more cost effective and less invasive so it is preferred as first line of treatment and surgery is to be preserved for cases of recurrent symptoms after repeated dilatation, markedely dilated esophagus and associated other abdominal pathology that needs surgery or patient s preference.