[Heller's esocardiomyotomy without anti-reflux procedure by the laparoscopic approach. Analysis of a series of 27 cases].

From November 1992 to June 1996, 27 laparoscopic Heller's myotomies without antireflux procedure were performed. One mucosal tear occurred and was treated by open surgery. There was no mortality; one case of sepsis with a good outcome was observed on the converted patient. The mean length of hospital stay was 5.5 days. The immediate functional result was good in all cases. Postoperative esophageal manometry showed a significant reduction of the LES pressure, and post-operative pHmonitoring showed one case of reflux. The long term functional result was good in 81% of cases, moderate in 19% (slight reflux in 3 cases and dysphagia in 2 cases). No failure and no reoperation occurred in this series. This procedure has been applied to all patients with achalasia since December 1992.