Intraoperative distensibility measurement during laparoscopic Heller's myotomy for achalasia may reduce the myotomy length without compromising patient outcome

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
A IlczyszynA J Botha

Abstract

Our study aimed to assess whether intraoperative esophagogastric junction (EGJ) distensibility measurement using the EndoFLIP EF325 catheter (Crospon Ltd., Galway, Ireland) could potentially be used to guide laparoscopic Heller's myotomy (LHM), potentially modifying the operation outcome and comparing this clinically to our previous technique of gastroscopic assessment. Following a full diagnostic assessment with manometry and endoscopy patients with achalasia were divided into two groups. A retrospective cohort of patients operated on between 2007 and 2010 had a gastroscopy-guided LHM (G-LHM) with a standardized myotomy of 8 cm on the esophagus and 3 cm on the stomach. From 2010, patients were prospectively studied with an EndoFLIP-guided LHM (E-LHM). The length of the myotomy was dictated by intraoperative distensibility monitoring of the EGJ. All patients with achalasia recorded Urbach quality of life scoring preoperatively and 6 months postoperatively. A further group of normal laparoscopic control patients (E-LC) without any esophageal pathology also underwent intraoperative EGJ distensibility monitoring. Thirty-eight patients took part, 15 in the E-LC group, 8 in G-LHM group and 15 in the E-LHM group. We revealed that pat...Continue Reading

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Citations

Dec 26, 2016·Journal of Neurogastroenterology and Motility·Rona M Ata-Lawenko, Yeong Yeh Lee
Feb 23, 2018·The American Journal of Gastroenterology·Joseph R Triggs, Peter J Kahrilas
Sep 10, 2019·Journal of Digestive Diseases·Hui Min ChenQiang Cai
Aug 29, 2020·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Charlotte DesprezGuillaume Gourcerol
Apr 24, 2019·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Ayman El NakeebNabil Gad El-Hak
Feb 22, 2017·Current Gastroenterology Reports·Nitin K Ahuja, John O Clarke
Mar 8, 2017·Current Treatment Options in Gastroenterology·Dustin A Carlson, Ikuo Hirano
Aug 3, 2020·The American Journal of Gastroenterology·Edoardo SavarinoC Prakash Gyawali
Nov 25, 2020·World Journal of Surgery·Elizabeth H BruendermanFarid J Kehdy

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