Malynovskyy A. Low-invasive methods of treatment of esophageal achalasia.

The aim of dissertation is to improve the results of surgical treatment of esophageal achalasia using modernized low-invasive techniques - laparoscopic Heller cardiomyotomy and balloon dilation. The long-term results of treatment of 115 patients with different stages of esophageal achalasia were studied. The laparoscopic cardiomyotomy proved to have lesser recurrence, gastroesophageal reflux and postoperative complacations rates than transthoracic cardiomyotomy. Thus, laparoscopic cardiomyotomy is the treatment of choise of esophageal achalasia of II, III and IV degree. Using of modernized techniques of laparoscopic cardiomyotomy excludes the possibility of intraoperative mucosal perforation and postoperative esophageal leakage. The distinct indications for the fundoplication while laparoscopic cardiomyotomy were developed to decrease recurrence rate. The balloon dilation proved to be the treatment of choice of the I stage of esophageal achalasia. Therefore, the dissertation includes the first analysisof the results of low-invasive methods of treatment of esophageal achalasia, proved their advantages and created the distinct indications for these techniques.