الفهرس 
Introductionيوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
SUMMARY
A
chalasia is an incurable primary motor disorder of the esophagus. Its characteristic manometric features are esophageal body aperistalsis and insuffcient relaxation of a frequently hypertensive lower esophageal sphincter in response to swallowing. As the pathogenesis of achalasia is not well understood, the treatment is palliative, aiming at relieving the obstruction at the gastroesophageal junction.
The best treatment modality for achalasia is still controversial. Studies comparing EPD with laparoscopic Heller Cairdomyotomy (LHM) reported contradicting results. Some authors reported similar long-term outcome for both EPD and LHM, whereas other studies showed superiority of LHM.
In this study, all patients were assesed through High resolution manometry and symptomatic asessment was done through Demeester grading score.
Laparoscopic Heller myotomy is the favourable decision for patients with type I characterized by being young age, high Demeester score (>7), severe elevation in LES pressure more than 35 mmHg, type II and type III(with longer myotomy), while balloon dilatation is suitable for type I achalasia patient characterized by being old age, low Demeester score and with mild to moderate elevation in LES pressure < 35 mmHg