Six years of experience in laparoscopic surgery of esophageal achalasia

Fernández, Albert Noguera; Martínez, Marina Alejandra González; Ruiz, J Padillo; Torres, Rafael A.; Faife, Bárbara C. Faife; Torres, Jarol; Escoto, C.M.

doi:10.1007/s00464-002-8576-5

Cited by 19 publications

(8 citation statements)

References 9 publications

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“…Rosati and colleagues [8] performed laparoscopic Heller myotomy and Dor fundoplication on 61 patients, and reported favorable results: excellent in 87.9% and good in 10.3%. In addition, Fernandez and colleagues [2] performed either laparoscopic Heller myotomy and Dor fundoplication or Heller myotomy and Toupet fundoplication on 110 patients, and obtained extremely favorable results: excellent in 103 patients and good in three patients. However, these authors did not describe preoperative disease states.…”

Section: Discussionmentioning

confidence: 95%

Laparoscopic Heller myotomy and Dor fundoplication for the treatment of achalasia

et al. 2005

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Section: Discussionmentioning

confidence: 95%

Laparoscopic Heller myotomy and Dor fundoplication for the treatment of achalasia

et al. 2005

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“…The severity of symptoms was evaluated by a modified symptom score [17] , which consisted of the sum of the scores for dysphagia, regurgitation and chest pain. Recurrent achalasia is defined as recurrence of severe symptoms of dysphagia, regurgitation or chest pain (symptom scores of 2 or 3), and the need for intervention again, or repeat HM [18][19][20][21][22] . Data regarding the first author, year of publication, first-line treatment, operation duration, median hospital stay, and symptoms remission rate, were extracted.…”

Section: Study Selection and Data Analysismentioning

confidence: 99%

Recurrent achalasia treated with Heller myotomy: A review of the literature

Wang¹,

Li²

2008

WJG

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AIM:To evaluate the efficacy and safety of Heller myotomy (HM) for recurrent achalasia, performed after different methods of first-line treatment. METHODS:We searched for studies published in PubMed from 1966 to March 2008 on treatment of recurrent achalasia with HM after failure with different methods of first-line treatment. The efficacy of HM was assessed by a pooled estimate of response rate with individual studies weighted proportionally to sample size. RESULTS: Sixteen studies were eligible and included in the review. The results showed that HM has a better remission rate for recurrent achalasia after failure of HM [weighted mean (SD)] of 86.9% (21.8%) compared with 81.6% (23.8%) for pneumatic dilatation (PD). One study evaluated the efficacy of HM after failure of PD combined with botulinum toxin injection (83%). The most common complications were perforation and gastroesophageal reflux. CONCLUSION: HM has the best efficacy in patients with recurrent achalasia who were treated with HM as first-line treatment. Future studies should focus on how to increase the success rate and decrease the complications of HM.

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“…Later, the Heller myotomy was combined with Dor fundoplication to prevent postoperative gastroesophageal reflux 23,24 . Currently, LHD is widely performed as the standard surgery for achalasia, 6,7,25–27 and its results has been reported to range from 88% to 97% 28–35 . Recently, the long‐term surgical results have been reported, 36–38 and the safety and efficacy of LHD have been proven.…”

Section: Discussionmentioning

confidence: 99%

Results after laparoscopic Heller-Dor operation for esophageal achalasia in 100 consecutive patients

Tsuboi

Omura

Yano

et al. 2009

Diseases of the Esophagus

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The laparoscopic Heller-Dor operation has been the procedure of choice for the treatment of achalasia. However, because the incidence of achalasia is low, reports on the outcome of surgical treatment for achalasia are limited. In this study, the therapeutic results after laparoscopic Heller-Dor operation for achalasia at a single university hospital were evaluated. Between August 1994 and July 2006, 100 consecutive patients underwent laparoscopic Heller-Dor operation. The therapeutic results after laparoscopic Heller-Dor operation were assessed based on complications, operation time, blood loss, postoperative hospital stay, and the standardized questionnaire for satisfaction by telephone or outpatient clinic interview. With respect to perioperative complications, lower esophageal mucosal perforation occurred in 14 patients, but all of them could be suture-obliterated laparoscopically. One patient was converted to laparotomy because of uncontrolled bleeding from the short gastric artery. The mean operative time was 169 minutes, and the mean perioperative blood loss was 22 mL. The median postoperative hospital stay was 7 days. Reflux esophagitis, which was seen in five patients, was treated successfully with a proton pump inhibitor. According to the standardized questionnaire for satisfaction, 77 patients rated their recovery as 'excellent', 17 as 'good', 4 as 'fair', and 2 as 'poor'; thus, the overall success rate was 94%. There were no significant differences in surgical outcomes by morphologic type and severity of esophageal dilatation; however, the success rate deteriorated significantly with progression of the morphologic type. Laparoscopic Heller-Dor operation is a safe and effective surgical treatment for achalasia.

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Six years of experience in laparoscopic surgery of esophageal achalasia

Abstract: This surgical procedure is a first line in the treatment of esophageal achalasia. It is necessary to have special care in early diagnostic cases to avoid electrosurgical injury.

Cited by 19 publications

References 9 publications

Laparoscopic Heller myotomy and Dor fundoplication for the treatment of achalasia

Laparoscopic Heller myotomy and Dor fundoplication for the treatment of achalasia

Recurrent achalasia treated with Heller myotomy: A review of the literature

Results after laparoscopic Heller-Dor operation for esophageal achalasia in 100 consecutive patients

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