Laparoscopic-modified Heller esophagocardiomyotomy is the standard treatment for patients with achalasia. Long-term patient satisfaction exceeds 90%. An antireflux procedure can reduce postoperative heartburn rates by 80% and reduce risk of esophagitis and peptic stricture. A Dor or Toupet fundoplication reduces reflux as well as a Nissen, but the partial wraps trend toward lessdysphagia.
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