Methods. We analyzed immediate results of surgery in 92 patients with different stages of esophageal achalasia: 53 patients with laparotomic cardiomyotomy, 39 patients — Heller laparoscopic cardiomyotomy.
Results. Laparoscopic esophagocardiomyotomy is characterized by a lower incidence of intraoperative complications than laparotomy (2.5 and 11.3%, respectively), 4.2 times less blood loss, postoperative complications and length of hospital stay ((5.5±0.1) and (11.1±1.0) days, respectively). Recovery of food passage achieved in all patients, even with stage IV disease, pathological gastroesophageal reflux not observed. Average passage in the control group was 6.7±0.9, and in the main group — 8.1±0.8, is not significantly different. All patients in both groups achieved excellent and good immediate results. We registered reduction symptoms of retrosternal pain, regurgitation and dysphagia. Clinical symptoms of esophagitis disappeared in all patients; almost all patients had I (A) the degree of heartburn.
Conclusions. Improved methods of operation using high-frequency welding technology ensures rapid, bloodless and low-impact performance exstramucosal esophagocardiomyotomy followed fundoplication, which makes it possible to perform an operation without imposing a significant number of stitches and reduce operation time, thereby reducing intra- and postoperative complications. Esophagocardiomyotomy with fundoplication allows restoring patency of the esophagus in all patients, regardless of disease stage and method of operation (laparoscopic and laparotomic). All patients achieved good results of surgical treatment.