Intraoperative High Resolution Manometry for tailored Heller myotomy in esophageal achalasia: could it give better results?

Introduction. Esophageal achalasia is a rare primary motility disorder characterized by impaired lower esophageal sphincter relaxation and absence of esophageal body peristalsis. Achalasia is classified by the Chicago Classification in type I, type II and type III. The present study evaluates how the use of intraoperative high resolution esophageal manometry (IHREM), driving the exact extension of myotomy throughout the esophagus, could improve outcome in achalasic patients, expecially in type III achalasia. Materials and Methods: 49 achalasic patients underwent laparoscopic Heller myotomy and Dor fundoplication: 25 patients (Group 1: 16 type II achalsia, 7 type III achalasia and 2 type I a…