Results of laparoscopic Heller myotomy without anti-reflux procedure in achalasia. Monocentric prospective study of 106 cases

Abstract

Laparoscopic HM without anti-reflux procedure gives good functional results provided the anatomical fixation of the GOJ is respected.

Laparoscopic Dor versus Toupet fundoplication following Heller myotomy for achalasia: results of a multicenter, prospective, randomized-controlled trial

“…This procedure has been shown to result in effective relief of dysphagia symptoms and improved quality of life, and has a low morbidity rate [1,2]. The issue of whether Heller myotomy should be accompanied by an antireflux operation has been debated, and there are some groups that have reported low rates of physiologic reflux after myotomy alone [10]. However, a high incidence of abnormal reflux after isolated myotomy has also been observed when physiologic testing is done [11,12], and the results from two prospective, randomized trials [4,13] (see below) have persuaded most surgeons to add an antireflux procedure to the myotomy.…”

Laparoscopic oesophageal cardiomyotomy without fundoplication in children with achalasia: a 10-year experience

“…Further results in adults suggest that laparoscopic fundoplication after cardiomyotomy is safe and effective with excellent results in terms of dysphagia resolution, and protection from the onset of GOR [16]. However, previous studies demonstrate that the incidence of GOR following cardiomyotomy is low, even without fundoplication [17][18][19]. This might be due to the fact that dissection during laparoscopy is less extensive, preserving the physiological mechanisms that protect against GOR, particularly by preserving the angle of His [19].…”

“…However, previous studies demonstrate that the incidence of GOR following cardiomyotomy is low, even without fundoplication [17][18][19]. This might be due to the fact that dissection during laparoscopy is less extensive, preserving the physiological mechanisms that protect against GOR, particularly by preserving the angle of His [19]. Carrying out an additional anti-reflux procedure could potentially lead to recurrence of symptoms by increasing the resistance to the outflow from the oesophagus, in the context of persisting hypoperistalsis.…”

Minimal Access Surgery (Laparoscopic Cardiomyotomy) for Achalasia Cardia

“…They concluded the study suggesting that minimal access surgery is a safe and effective treatment for achalasia cardia. 106 patients were studied by M Robert, et al 15 proving that the morbidity rate with average follow-up of 55 months was very less. They stressed the importance of the minimal access cardiomyotomy which gives good functional results.…”