Laparoscopic Heller myotomy relieves dysphagia in patients with achalasia and low LES pressure following pneumatic dilatation

Background: Although pneumatic dilatation is said to relieve dysphagia in achalasia if it decreases lower esophageal sphincter (LES) pressure to 10 mmHg (n = 23); group C, no previous balloon dilatation and LES pressure >10 mmHg (n = 25). All patients underwent a laparoscopic Heller myot omy and Dor fundoplication. The severity of dysphagia was gauged on a scale of 0-4. Results: In group A, LES pressure was 7 ± 2 mmHg preoperatively and 8 ± 3 mmHg postoperatively; the dysphagia score was 3.3 ± 0.7 preoperatively and 0.9 ± 1.1 postoperatively. Eighty-nine percent of patients had excellent or good results. In group B, LES pressure was 23 ± 8 mmHg preoperatively and 10 ± 1 mmHg postoperatively; the dysphagia score was 3.3 ± 0.7 preoperatively and 0.3 ± 0.5 postoperatively. All patients had excellent or good results. In group C, LES pressure was 23 ± 11 mmHg preoperatively and 14 ± 12 mmHg postoperatively; the dysphagia score was 3.6 ± 0.6 preoperatively and 0.2 ± 0.5 postoperatively. All patients had excellent or good results. Conclusions: These results show that (a) a LES pressure of