Hani M.S.M. Kadhm Akram Hadi Hamza


Background: Achalasia is a primary disorder of the esophagus, of unknown etiology, characterized by degeneration of the myenteric plexus, resulting in impaired relaxation of the gastroesophageal junction (GEJ), together with loss of peristalsis of the body of the esophagus. Laparoscopic Heller’s Myotomy is the first- line surgical therapy for achalasia; it has a response rate of 90–97% with recurrent dysphagia in 3–10% of patients. Laparoscopic incision is made anteriorly from 6 cm above the GEJ to 3 cm beyond, preserving cardio-oesophageal fat and the anterior vagus nerve. Objective: To assess the management of achalasia. Patients and method: A retrospective and prospective cohort study that carried out in the Gastroenterology and Hepatology Teaching Hospital in Medical city Complex in the period from the first of January 2019 to the end of Jun 2022. A sample of 25 patients who were diagnosed with achalasia according to clinical presentation and proved by barium swallow. Results: The current study included 25 patients, female was presented in 13 (52%) and male was found in 12(48%) with female to male ratio (1.08:1). Dysphagia was presented in all patients (100%), then weight loss in 19/25 (76%) of patients, then regurgitation was found in 18/25 (72%) of cases. Complications happened as emphysema in one case 1/25 (4%) and simple chest infection in 2/25 (8%) cases (1 for male and other 1 for female).Conclusion: More than half of the achalasia patients were treated with Pneumatic dilatation (56%) while (44%) were treated by surgery. laparotomy done for (8.0%), and laparoscopy was done in (36.0%) of cases.

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Achalasia, Laparoscopic Heller’s Myotomy, Dysphagia.

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