Best treatment for achalasia is surely laparoscopic myotomy + an anti-reflux procedure. Balloon dilatation &/or POEM are vibrant alternatives but the latter is associated with increased GERD and also long-term data is not available.
What must be done if you open the mucosa during a myotomy. ? This risk is reported to be as high as 10 % and we encountered 2 among 40+ myotomies.
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