The goal of this prospective observational study is to evaluate the role of nasogastric tube (NGT) in patients with achalasia underwent to Heller-Dor laparoscopic. The main question it aims to answer are:

• If it is possible to remove NGT at the end of surgery. Participants will be dived in two groups: the first one with NGT after surgery and second one without NGT (noNGT).

If there is a comparison group: Researchers will compare group NGT and group noNGT to see if routine placement of NGT is useless.

Achalasia is a rare disease characterized by dysfunction of low oesophageal sphincter. This disease is divided according to Chicago classification into three subtypes.

Laparoscopic Heller - Dor is a important treatment of types I and II Achalasia. There are several studies evaluating the NGT in colorectal, hepatic, urologic, thoracic, otorhinolaryngology, gastric and esophageal surgery. Its use in postoperative period in achalasic patients is not yet clear.

Historically, NGT has been used to reduce gastric distention, nausea, vomiting and chest pain.

The aim of our study is to value the role of NGT for this surgery. We prospectively enrolled achalasic patients undergoing laparoscopic Heller -Dor .

The NGT group and noNGT were compared in terms of perioperative outcomes.

Inclusion Criteria:

• patients with achalasia of type I and II
• patients undergoing laparoscopic Heller-Dor
• patients older than 18 years
• both sexes

Exclusion Criteria:

• pregnant patients;
• patients a history of abdominal surgery;
• body mass index (BMI) >40;
• American Society of Anesthesiology (ASA) score >4;
• megaesophagus;
• III type Achalasia;
• previously treated for this disease.

Each patient has type I or type II esophageal achalasia and was treated with the Heller-Dor laparoscopic surgery.

Patients Number Length of stay (day) First flatus (day) Intake liquid diet (day) Intake semi-solid diet (day) Intraoperative complications

Postoperative complications:

• Grade I
• Grade II