[Current treatment of esophageal achalasia. Surgeons' opinion]

This present paper is proposing a presentation of the current therapeutical possibilities in the esophageal achalazia. This severe esophagian motility disorder is profiting, in the current context of minim invasive therapy, of either pneumatic dilatation, either esocardiomyotonomy. Both methods have given favorable results, but degradable in time. Starting from the experience of my gastroentheriologists colleagues, presented in previous papers, we insist on minim invasive therapeutical gestures. And, because the pneumatical dilatation, besides the smaller percentage of favorable results and the need of being periodically repeated, determines anatomical alterations of the esopagian junction that make difficult and even dangerous the surgical intervention, we plead for esocardiomyotonomy from the beginning. The possibility of operating videooscopically is imposing this therapeutical method. Regarding the videoscopic alternative, we are pleading for the abdominal way and for the Bailey esomyotomy or Heller esocardiomyotomy with fundoplicatura.