Factors associated with postoperative symptoms after laparoscopic Heller myotomy

The Annals of Thoracic Surgery
C FinleyR J Finley

Abstract

Our objective is to ascertain if preoperative and perioperative treatments affect the short- and long-term symptom frequency or symptom scores for dysphagia, regurgitation, and heartburn in patients with laparoscopic Heller myotomy for achalasia. From 1994 to 2008, 261 patients undergoing laparoscopic esophageal myotomy were enrolled prospectively. The diagnosis of classic achalasia was made on clinical history, barium swallow, endoscopy, and manometry. A validated symptom questionnaire and history was taken for each patient at the preoperative visit and at each postoperative visit. In all, 261 patients had laparoscopic Heller myotomy during the study period. Preoperatively, 137 patients (62.3%) tried medications, 101 (38.7%) were treated with pneumatic dilation, and 29 (11.1%) were treated initially with at least one injection of botulinum toxin into the lower esophageal sphincter. In all, 134 patients (51.3%) received a Dor anterior fundoplication. On multivariate regression controlling for age and sex, preoperative dilation (p = 0.031), injection of botulinum toxin (p = 0.044), and a fundoplication (p = 0.005) were associated with significantly worse early postoperative dysphagia, with odds ratios of 2.11, 2.56, and 2.80, re...Continue Reading

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Citations

Jul 2, 2011·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Stefano PontoneFilippo Custureri
Oct 5, 2011·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Marco G Patti, Carlos A Pellegrini
Jun 16, 2011·General Thoracic and Cardiovascular Surgery·Hideyuki Kashiwagi, Nobuo Omura
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Sep 11, 2010·The Journal of Thoracic and Cardiovascular Surgery·Sandro MattioliFrank D'Ovidio
Jan 28, 2010·The Annals of Thoracic Surgery·Raja M Flores
Jul 23, 2013·Lancet·Guy E BoeckxstaensJoel E Richter
Apr 1, 2015·Nature Reviews. Gastroenterology & Hepatology·Jan Tack, Giovanni Zaninotto
Mar 24, 2015·Gastrointestinal Endoscopy·UNKNOWN American Society for Gastrointestinal Endoscopy PIVI CommitteeLee L Swanstrom
Jan 19, 2017·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Francisco SchlottmannMarco G Patti
Apr 5, 2017·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·H GuoT Ling
Jan 17, 2019·Scandinavian Journal of Gastroenterology·Helge EvensenAsle W Medhus
Apr 30, 2019·Current Opinion in Gastroenterology·Giovanni ZaninottoSheraz R Markar
Nov 30, 2016·World Journal of Gastroenterology : WJG·Xue-Hong WangDe-Liang Liu
Apr 24, 2019·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Ayman El NakeebNabil Gad El-Hak
Sep 1, 2018·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·G ZaninottoD E Low
Jun 17, 2020·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Lydia S WattsWilliam L Hasler

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