Laparoscopic Heller miotomy with Dor fundoplication in the management of achalasia – long-term outcome
Journal Title: Postępy Nauk Medycznych - Year 2011, Vol 24, Issue 1
Abstract
Background. Achalasia is a rare primary motility disorder of the esophagus of unknown etiology. Loss of esophageal peristalsis and inability of the lower esophageal sphincter to relax leads to clinical hallmark – dysphagia. As esophageal outlet obstruction becomes more pronounced, other symptoms such as weight loss, regurgitation, vomiting, chest pain, dyspnea and heartburn arise. Although limited high-quality data exist, it appears that laparoscopic Heller myotomy with partial fundoplication is superior to endoscopic methods in achieving long-term relief of symptoms in the majority of patients. This study was undertaken to determine long-term outcomes after laparoscopic Heller myotomy for treatmentof of achalasia with simultaneously Dor fundoplication done as a prophylactic antireflux procedure.Material and methods. Retrospective assessment of the series of patients treated in the years 2000-2006 for esophageal achalasia by laparoscopic Heller myotomy with Dor fundoplication. Patients scored typical symptoms seen in esophageal achalasia using a Likert scale with choices ranging from 0 (never/not bothersome) to 10 (always/very bothersome). Symptom scores before and after surgical procedure were compared. Results. In the years 2000-2006 fifteen patients were treated for achalasia by laparoscopic Heller myotomy with Dor fundoplication. Most of the patients (93.3%) reported symptom control overall to be good or excellent in at least 4 years follow-up.Conclusions. Laparoscopic Heller myotomy with Dor fundoplication is a highly effective and safe surgical procedure for treatment of esophageal achalasia.
Authors and Affiliations
Adam Ciesielski, Wiesław Tarnowski, Aleksander Grous, Naser Dib
Keywords
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