Late Evaluation of Dysphagia After Heller Esophageal Myotomy With Dor Fundoplication for Achalasia

Câmara, Eduardo Rodrigues Zarco; Madureira, Fernando Athayde Veloso; Madureira, Delta; Salomão, Renato Manganelli; Iglesias, Antonio

doi:10.1590/0102-6720201700030005

Cited by 2 publications

(1 citation statement)

References 20 publications

(27 reference statements)

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“…Achalasia or megaesophagus is a disease whose most common etiologies are of chagasic or idiopathic origin. It can affect any gender and age and lead to a considerable deterioration in the patient’s quality of life 2 , 13 , 26 , 38 .…”

Section: Introductionmentioning

confidence: 99%

Short and Long-Term Results of Laparoscopic Esophagocardiomyotomy With Fundoplication (Heller-Pinotti Surgery) in the Treatment of Non-Advanced Achalasia (Megaesophagus)

CHADU JUNIOR,

OLIVEIRA,

FAION

et al. 2024

ABCD, arq. bras. cir. dig.

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BACKGROUND: Videolaparoscopic esophagocardiomyotomy with fundoplication has been a widely used technique for the treatment of achalasia. This study analyzes the safety and effectiveness of the technique in the treatment of non-advanced achalasia (megaesophagus) in a Brazilian federal university public hospital. AIMS: To evaluate the short- and long-term results of videolaparoscopic treatment of non-advanced megaesophagus in a public university hospital in Brazil, employing the esophagocardiomyotomy technique with fundoplication. METHODS: The medical records of 44 patients who underwent surgical treatment for non-advanced achalasia at the Clinical Hospital of Federal University of Uberlândia (UFU-MG), Minas Gerais, from January 2001 to July 2021 were analyzed. The following data were evaluated: gender, age, etiology, radiological classification of Rezende-Alves and Ferreira-Santos, immediate and late complications (mean follow-up of 31.4 months), need or not for conversion to open access, postoperative reflux, performance or not of endoscopic esophageal dilation in the preoperative period, postoperative mortality, frequency of pre and postoperative symptoms (persistent dysphagia, regurgitation, heartburn, vomiting, odynophagia, and weight loss), surgery time, hospital stay, duration of dysphagia, pre and postoperative weight, and Eckardt score. RESULTS: Among the analyzed patients, 23 (52.3%) were male, and 21 (47.7%) were female, with a mean age of 50.8 years. No early complications were recorded and there were 27.2% cases of late gastroesophageal reflux. Postoperative weight gain was 81.8% and the success rate of surgery according to the Eckardt score was 84.1%. CONCLUSIONS: Esophagocardiomyotomy with fundoplication is an effective and safe technique for the treatment of non-advanced achalasia.

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Section: Introductionmentioning

confidence: 99%

Short and Long-Term Results of Laparoscopic Esophagocardiomyotomy With Fundoplication (Heller-Pinotti Surgery) in the Treatment of Non-Advanced Achalasia (Megaesophagus)

CHADU JUNIOR,

OLIVEIRA,

FAION

et al. 2024

ABCD, arq. bras. cir. dig.

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Determining long-term outcome of transthoracic Heller's myotomy when other methods fail: A single centere cases series

Baram

Essa

2019

International Journal of Surgery Open

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Objective: We aimed to estimate the long-term outcomes of transthoracic Heller's myotomy without fundoplication. Methods: This single centere, retrospective study included patients followed up for signs of cure, recurrence of symptoms, and different aspects of quality of life estimated over several years. Data were obtained directly from the patients and the medical records. The scores of patients with early and late dysphagia were compared preoperatively and postoperatively to estimate the quality of life (QoL). Results: A total of 48 patients (37 women and 11 men) who underwent surgery for achalasia between 2008 and 2018 were included. The mean age was 43.5 (19–68) years. The mean follow-up duration was 60.5 (1–120) months. Dysphagia, regurgitation, and heartburn were the most common symptoms, occurring in 100% of patients. The outcomes were an excellent success rate and estimation of QoL. After the first 6 months of follow-up, patients who underwent surgery developed grades 1–3 dysphagia. After 1–10 years of follow-up, 39 (81.25%) patients had grade 1 dysphagia, whereas 9 (18.75%) still had grade 2 dysphagia. During the long-term follow-up, only 77% of patients developed regurgitation, while 91.6% had heartburn. QoL changed according to dysphagia scores (from 5 to 1). However, the score of 26 patients (54.16%) decreased to 1; after 1 year of follow-up, 42 patients (87.5%) obtained a dysphagia score of 1. After 1–10 years of follow-up, 97.2% of patients underwent barium oesophagogram and showed a small-calibre oesophagus. Conclusion: Transthoracic Heller's myotomy is a safe and durable procedure that is associated with a durable long-term success rate and less recurrence, without necessity for any type of anti-reflux surgery. Highlights:

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Late Evaluation of Dysphagia After Heller Esophageal Myotomy With Dor Fundoplication for Achalasia

Cited by 2 publications

References 20 publications

Short and Long-Term Results of Laparoscopic Esophagocardiomyotomy With Fundoplication (Heller-Pinotti Surgery) in the Treatment of Non-Advanced Achalasia (Megaesophagus)

Short and Long-Term Results of Laparoscopic Esophagocardiomyotomy With Fundoplication (Heller-Pinotti Surgery) in the Treatment of Non-Advanced Achalasia (Megaesophagus)

Determining long-term outcome of transthoracic Heller's myotomy when other methods fail: A single centere cases series

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