Evaluation of the Functional Outcome of Laparoscopic Heller Cardiomyotomy in Treatment of Patients with Achalasia of the Cardia

Abstract

Background: Achalasia is an esophageal motor disorder characterized by increased lower esophageal sphincter (LES) pressure and diminished or absent peristalsis in the distal esophagus. This trial assessed the functional Outcome of laparoscopic Heller cardiomyotomy in treatment of patients with achalasia of the cardia using the Eckardt score. Methods: This prospective randomized trial included 30 patients with Achalasia of the cardia. These patients were managed at Banha and Mansoura University Hospitals by doing laparoscopic Heller cardiomyotomy. Follow-up was planned for 6 months for Eckardt score. Results: There was a statistically significant decrease in Eckardt score in all patients who done laparoscopic Heller cardiomyotomy (P<0.001) and 7% of patients (2 patients) had esophageal perforation and management done intraoperative with good improvement in the follow up. Conclusions: According to presented evidence, laparoscopic myotomy with anti-reflux procedures is the optimal first-line treatment for achalasia with a satisfactory improvement in quality of life.