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J Laparoendosc Adv Surg Tech A. 2006 Dec;16(6):587-92.

Distal esophageal perforation repair during laparoscopic esophagomyotomy: evaluation of outcomes and review of surgical technique.

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  • 1Endoscopic Surgery Division, Hospital General Dr. Manuel Gea Gonz├ílez, Mexico City, Mexico. pfreddy@telcel.net.ve



To describe the technique employed and our experience with primary laparoscopic repair of distal esophageal perforations produced during laparoscopic esophagomyotomy, as well as to evaluate the outcomes.


We analyzed six cases of patients with primary achalasia in whom distal esophageal mucosal perforations were caused during laparoscopic esophagomyotomy. A primary repair and fundoplication was performed in five cases; in the sixth patient, the perforation could not be recognized during the surgical procedure. The postoperative follow-up included clinical evaluation, upper gastrointestinal endoscopy, esophageal manometry, and ambulatory 24-h esophageal pH monitoring.


Five patients reported dysphagia relief and were highly satisfied with the final surgical outcome. In one case we observed an altered postoperative 24-h esophageal pH. Two patients developed esophageal leakage, one with a fatal outcome.


The primary repair of distal esophageal perforations during laparoscopic esophagomyotomy is a valid therapeutic option and does not alter the surgical purpose. However, if the perforation is not recognized early on, the prognosis can change.

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