The Outcome of Laparoscopic Surgery With and Without Short Gastric Vessel Division for Achalasia

Abstract

Short gastric vessel division (SGVD) has been performed as a part of fundoplication for achalasia. However, whether or not SGVD is necessary is still unknown. Forty-six patients with achalasia who underwent a laparoscopic surgery with or without SGVD were analyzed. A questionnaire was administered to assess the postoperative improvement. Regarding improvement of dysphagia and postoperative reflux, there were no significant differences between SGVD (þ) group and SGVD (À) group (P ¼ 0.588 and P ¼ 0.686, respectively). Nineteen patients (95%) in the SGVD (þ) group and 24 (92%) in the SGVD (À) group answered that the surgery was satisfactory (P ¼ 0.756). In the SGVD (þ) group, the pre-and postsurgical body weight increase was þ7.3%. In the SGVD (À) group, it was 8.2%. There was no significant difference of body weight increase between the 2 groups (P ¼ 0.354). SGVD is not always required in laparoscopic surgery for achalasia.Key words: Achalasia -Fundoplication -Short gastric vessels -Heller-Dor A chalasia is a well-known functional disorder of the esophagus. Although its causes have not yet been clearly revealed, the main mechanism is thought to be the degeneration of the Auerbach's plexus, which causes the insufficiency of relaxation of the lower esophageal sphincter muscle. The first surgical case of achalasia was reported by Rumpel in 1987, 1 and today's standard therapeutic procedure consists of myotomy to improve the passage and half-fundoplication to avoid reflux after surgery. 2,3As of result of the recent developments in laparoscopic surgery, the surgical procedure has also been changed for achalasia surgery, and laparoscopic