[Heller myotomy by transthoracic procedure, a single center experience in Mali with 21 cases].

Aims: To evaluate the midterm results of myotomy for achalasia by thoracotomy procedure with the introduction of anti-reflux system by diaphragmatic flap.

Patients And Methods: This was a prospective study involved 21 patients (14 women and 7 men) operated for idiopathic megaesophagus during a period of 3 years. All the patients were operated by thoracotomy procedure. An anti-reflux system was performed using a diaphragmatic flap over the entire length of the myotomy.

Results: The mean age was 32 years (range 16 and 68 years). After the surgery we have seen a complete disappearance of dysphagia in 21 patients (100 %) (p <0.001) and a significant weight regain. Short term outcomes were marked by the occurrence of clinical gastroesophageal reflux disease in 1 patient (4.76%) who has received the anti-reflux system (p> 0.05).

Conclusion: Oeso-cardio-myotomy of Heller by transthoracic procedure associated with the establishment of an anti reflux system by diaphragmatic flap has goods results.