Achalasia: the case for primary laparoscopic treatment

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
C PeillonF Siriser

Abstract

Laparoscopic Heller myotomy offers the best-known surgical therapy for esophageal achalasia. Nevertheless, this procedure continues to compete with alternative endoscopic treatment and is often considered only as a secondary resort. In this study, the authors performed a review of the results of laparoscopic Heller myotomy and an evaluation of the impact of previous endoscopic treatment regarding perioperative complications and late results. Twenty-seven patients with achalasia confirmed by a manometry examination underwent a primary laparoscopic Heller myotomy (group 1, n = 14) or experienced endoscopic treatment failure (group 2, n = 13). A dysphagia score (0-4) was obtained before and after surgery. Clinical course was reviewed at 2 months and then every 6 months after surgery. In December 1999, patients answered a questionnaire regarding surgery satisfaction, postoperative reflux, and dysphagia for statistical analysis. There were no deaths. Mean hospital stay was 5.6 days. Three perforations occurred in group 2 (25%) versus one in group 1 (6%) (not statistically significant). At a mean 27-month follow-up, the dysphagia score was significantly (P < 0.001) improved in both groups but more significantly in group 1 versus grou...Continue Reading

References

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Citations

Nov 3, 2011·Surgical Endoscopy·Dimitrios StefanidisUNKNOWN Society of American Gastrointestinal and Endoscopic Surgeons
Oct 1, 2009·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Christopher W SnyderMary T Hawn
Mar 10, 2004·American Journal of Surgery·Mark BloomstonAlexander S Rosemurgy
Feb 11, 2015·PloS One·Hitomi MinamiKazuhiko Nakao

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