Achalasia of the cardia: long-term results of oesophagomyotomy and posterior partial fundoplication.

摘要: Forty-eight patients with achalasia of the cardia were treated by Heller's myotomy a posterior fundoplication approximately 270 degrees, suturing gastric fundus to edges myotomy. The mean(s.d.) postoperative follow-up period was 5.4(2.8) years. clinical results good excellent in 44 cases (92 per cent) and fair four (8 (two residual dysphagia two gastrooesophageal reflux). Barium studies showed decrease oesophageal diameter disappearance distal narrowing but normal emptying did not occur. Postoperative manometric (29 patients) revealed significant lower sphincter pressure increase length infradiaphragmatic segment. In body recovery peristaltic waves proximal third seen ten (34 cent). Twenty-four-hour pH monitoring pathological reflux only three 25 studied, one these asymptomatic. This technique is effective, improving symptoms controlling long-term reflux.