• T C B Dehn, M Slater, N J Trudgill, P M Safranek, and M I Booth.
• Department of Upper Gastrointestinal Surgery, Royal Berkshire Hospital, Reading, UK. Thomas.Dehn@royalberkshire.nhs.uk
• Br J Surg. 2012 Sep 1;99(9):1242-5.

BackgroundTreatment of primary achalasia includes injection of botulinum toxin, pneumatic dilatation or surgical myotomy. All of these procedures have an associated failure rate. Laparoscopic stapled cardioplasty (LSC) may be an alternative to failed pneumatic dilatation and laparoscopic Heller's myotomy where oesophagectomy has previously been the only surgical option.MethodsSelected patients with recurrent achalasia following multiple failed medical treatments, including myotomies, were managed by LSC. Patients had postoperative contrast swallows before discharge with clinical follow-up.ResultsAll seven patients treated with LSC were discharged within 5 days. Rapid oesophageal emptying was noted on all post-LSC contrast swallows. No patient had an anastomotic leak. After 1 year, all but one patient was free from dysphagia, all had gained weight, and four patients had heartburn controlled by a proton pump inhibitor.ConclusionLSC may be a useful procedure for resistant achalasia.Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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