Minimally Invasive Surgical Treatment of Esophageal Achalasia

Abstract

Background. The article is devoted to the description and outcomes of conservative and surgical treatment of observed cases of achalasia cardia (AC). A brief literary review of the peculiarities of pathogenesis, clinical features as well as differential diagnosis of AС is presented. Objective. To analyze the treatment outcomes and evaluate the choice of the АС surgical treatment method. Material and methods. The analysis of treatment outcomes in 31 patients with AK confirmed by clinical, radiological and endoscopic findings was carried out. Results. 3 (10%) patients were opted for drug therapy only. Endoscopic balloon dilatation of the esophagus in combination with drug therapy was performed in 15 (48%) patients, mainly with stage II AC. The extent of surgical intervention in 16 (52%) operated patients was represented by laparoscopic Heller cardiomyotomy with Dor fundoplication. Conclusions. Laparoscopic Heller cardiomyotomy with Dor fundoplication for the prevention of gastroesophageal reflux was defined as the most effective surgical treatment of stage II-III AС. Endoscopic balloon dilatation of the esophagus combined with drug therapy is an effective treatment option for stage II AС, and can be used in stages II-III if there are contraindications for surgical treatment.