The objective of this study was to evaluate outcome of laparoscopic myotomy for achalasia, with or without antireflux procedure. Among 93 patients intended at the beginning for laparoscopic surgery, 4 patients had to be converted to open surgery for technical problems. The conversion rate was 4,3 percent. Only 89 patients were remained for analysis, including 40 males (44.9 percent) and 49 females (55.1 percent). Median age was 37 years old (range 16 - 72). Anti - reflux procedures consisted Nissen in 29 patients, Dor 37, Toupet 6 and 17 other patients without antireflux added. Morbidity and mortality: esophageal mucosal perforation occured in 5 patients, left pleural tear in 1 patient; acute peritonitis due to esophago-cardial mucosal leak occured at the 6th post operative day, without any perioperative mortality. Mean operative time: 137.4 +/- 46.67 mn (range 60 - 230); mean of hospital stay: 5.9 +/- 2.08 days (3 - 20). The long - term follow - up encountered in 79.8 percent. The mean follw - up time: 38.5 +/- 32.38 months (1 - 123). Dysphagia was relieved in all patients, with or without added anti-reflux procedure. Laparoscopic esophagocardiotomy is a safe, highly effective and minimally invasive treatment. It should be considered as the first line for the treatment of achalasia.
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