Achalasia: a 13-year, single-centre experience comparing endoscopic balloon dilatation and laparoscopic Heller myotomy.

Background: Idiopathic achalasia is a non-curable, primary motility disorder of the oesophagus. Most established long-term palliative treatment options are laparoscopic Heller myotomy (LHM) and endoscopic balloon dilatation (BD).

Aim: We aimed to compare the outcome of both therapies and the risk of serious complications, defined as perforation or death, in a single-centre series.

Wrapped in controversy: trends in fundoplication at myotomy for achalasia in Christchurch, New Zealand.

Aim: A surgical approach to the management of achalasia involves myotomy, typically with added anti-reflux procedure. The most appropriate fundoplication in this setting (total Nissen, partial anterior Dor, or partial posterior Toupet) remains controversial. We present the trends in fundoplication procedures performed at myotomy in Christchurch between 1997 and 2009, and compare this with the literature.

Post-acute surgical ward round proforma improves documentation.

In health care, record keeping of doctor-patient encounters is vital for quality patient care and medico-legal reasons. We audited the documentation of post-acute consultant ward round (PACWR) in our department before and six months after an introduction of a proforma (standard form). The clinical notes of all patients admitted acutely under General Surgery over a period of one week before and one week after the introduction of a proforma were reviewed to note whether time and date, signature, impression and dietary plan were documented after PACWR.