scholarly journals Long-Term Follow-up Results of Children Undergoing Achalasia Surgery

2021 ◽  
Author(s):  
Kutay Bahadır ◽  
Ergun Ergun ◽  
Anar Jafarov ◽  
Merve Bülbül ◽  
Gülnur Göllü ◽  
...  
Keyword(s):  
Heller Myotomy ◽  
Laparoscopic Heller Myotomy ◽  
Antireflux Procedure ◽  
Partial Fundoplication ◽  
Withdrawal Time ◽  
Average Hospital ◽  
Gold Standard Method ◽  
Study Results ◽  
Long Term Follow Up ◽  
The One

Objective: Achalasia is a disease characterized by lower esophageal sphincter motility disorder. Whereas there is no clear algorithm in treating achalasia in children, Heller myotomy is known to be as the most effective method. Gastroesophageal reflux after myotomy is a frequently reported complication. Therefore, the fundoplication procedure should be added to the myotomy simultaneously. Our study aimed to present the results of patients who underwent Heller myotomy and fundoplication for achalasia. Materails and Methods: Twelve patients who underwent laparoscopic Heller myotomy with the diagnosis of achalasia between the 2006 and 2019 have been included in the study. Results: There were 12 children. 75% of them were male, and 25% were female. Laparoscopic Heller myotomy and antireflux procedure were applied to all patients. The average nasogastric withdrawal time was 1.75 days, the average time to start feeding was 2.25 days. The average hospital stay was 6.75 days. Dysphagia persisted in 3 patients who underwent Dor fundoplication and in 1 patient who underwent Toupet fundoplication at postoperative 3rd-week controls. It was observed that the symptoms improved after the one-time endoscopic dilatation procedure. Conclusion: Heller myotomy is gold standard method in the treatment of achalasia in children.We believe that partial fundoplication added to myotomy reduces the risk of GER.

scholarly journals The Influence of Operation Technique on Long-Term Results of Achalasia Treatment

Medicina ◽  
2013 ◽  
Vol 49 (2) ◽  
pp. 10
Author(s):  
Mindaugas Kiudelis ◽  
Kristina Mechonosina ◽  
Antanas Mickevičius ◽  
Almantas Maleckas ◽  
Žilvinas Endzinas
Keyword(s):  
Heller Myotomy ◽  
Laparoscopic Heller Myotomy ◽  
Gastric Fundus ◽  
Long Term Results ◽  
Partial Fundoplication ◽  
Laparoscopic Operation ◽  
Study Results ◽  
Group 2 ◽  
Group 1

Currently, the most effective therapy for achalasia is laparoscopic Heller myotomy with partial fundoplication. The aim of this study was to compare the long-term results between 2 different laparoscopic operation techniques in achalasia treatment. Material and Methods. This was a retrospective study, where 46 achalasia patients were examined: 23 patients underwent laparoscopic Heller myotomy followed by the full gastric fundus mobilization, total hiatal dissection, and posterior Toupet (270°) fundoplication (group 1); other 23 patients underwent laparoscopic Heller myotomy with limited surgical cardia region dissection, not dividing the short gastric vessels and performing anterior partial Dor fundoplication (group 2). Long-term findings included the evaluation of postoperative dysphagia according Vantrappen and Hellemans and intensity of heartburn according the standard grading system. Results. The patients in these 2 groups were similar in terms of age, weight, height, and postoperative hospital stay. The median follow-up was 66 months in the group 1 and 39 months in the group 2 (P<0.05). Laparoscopic operation was effective in 82.6% of patients (excellent and good results) in the group 1; treatment was effective in 78.3% of patients in the group 2 (P>0.05). Clinically significant heartburn was documented in 39% of patients in the group 1 and only in 13% of patients in the group 2 (P<0.05). Conclusions. According our study results, both laparoscopic techniques were similarly effective (82.6% vs. 78.3%) in achalasia treatment. Postoperative heartburn was significantly more common (39% vs. 13%) after laparoscopic myotomy, followed by the full gastric fundus mobilization, total hiatal dissection, and posterior Toupet (270°) fundoplication.

Long-Term Outcomes of POEM for Primary Esophageal Motility Disorders

2021 ◽  
Author(s):  
Christine Tat ◽  
Matthew Kroh
Keyword(s):  
Esophageal Motility ◽  
Heller Myotomy ◽  
Symptomatic Relief ◽  
Laparoscopic Heller Myotomy ◽  
Esophageal Motility Disorders ◽  
Antireflux Procedure ◽  
Partial Fundoplication ◽  
Motility Disorders ◽  
Primary Esophageal Motility Disorders

AbstractSince peroral endoscopic myotomy (POEM) emerged in 2010 as a treatment for achalasia, more than 7,000 procedures have been performed in the world. The main indication for POEM continues to be achalasia, which is a rare esophageal motility disorder characterized by impaired lower esophageal sphincter relaxation and aperistalsis. POEM has also been applied in other types of primary esophageal motility disorders. Short-term outcomes indicate that POEM has comparable results to laparoscopic Heller myotomy in terms of efficacy and safety. Studies show decrease in Eckardt scores after POEM as a reflection of symptomatic relief. Now, a decade after its introduction, long-term data have emerged for POEM and demonstrates that POEM remains effective and safe. Both POEM and laparoscopic Heller myotomy are associated with postinterventional gastroesophageal reflux disease (GERD). Antireflux mechanisms are disrupted during the procedures. However, the rate of GERD is higher after POEM than with laparoscopic Heller myotomy. Laparoscopic Heller myotomy is commonly performed with a partial fundoplication to reduce antireflux, but POEM is not typically combined with an antireflux procedure. Further studies should examine the long-term effects of postinterventional GERD.

Mo1012 - Prevalence of Chest Pain in Patients with Achalasia after Laparoscopic Heller Myotomy and Partial Fundoplication: Long-Term Follow-Up

2018 ◽  
Vol 154 (6) ◽  
pp. S-1321
Author(s):  
Angélica Rodríguez-Garcés ◽  
Fernanda Romero-Hernández ◽  
Enrique Coss-Adame ◽  
Miguel A. Valdovinos ◽  
Janette Furuzawa-carballeda ◽  
...  
Keyword(s):  
Chest Pain ◽  
Heller Myotomy ◽  
Laparoscopic Heller Myotomy ◽  
Partial Fundoplication ◽  
Long Term Follow Up

scholarly journals Efficacy and Durability of Laparoscopic Heller Myotomy: Patient Symptoms and Satisfaction at Long Term Follow up

2011 ◽  
Vol 140 (5) ◽  
pp. S-1015
Author(s):  
John G. Linn ◽  
Anthony N. Chan ◽  
Sarwat Ahmad ◽  
Peter Muscarella ◽  
W.S. Melvin ◽  
...  
Keyword(s):  
Heller Myotomy ◽  
Laparoscopic Heller Myotomy ◽  
Long Term Follow Up

Heller Myotomy: To Wrap or Not to Wrap?

2018 ◽  
Vol 84 (6) ◽  
pp. 1022-1026
Author(s):  
Jordan Brown ◽  
Michael Egger ◽  
Farid J. Kehdy
Keyword(s):  
Effective Treatment ◽  
Heller Myotomy ◽  
Postoperative Outcomes ◽  
Antireflux Procedure ◽  
Partial Fundoplication ◽  
Esophageal Reflux ◽  
Postoperative Dysphagia ◽  
Reflux Symptoms ◽  
Postoperative Reflux ◽  
Mcnemar’S Test

Heller myotomy (HM) is widely recognized as the most effective treatment of achalasia. Although effective in improving dysphagia symptoms, HM is associated with reflux. Over a five-year period, 63 laparoscopic HM were performed. Patients underwent myotomy alone or HM plus reconstitution of the angle of His without any fundoplication, anterior, or posterior partial fundoplication. Two postoperative outcomes were examined: dysphagia and reflux. Twenty-two patients received no fundoplication (34.9%). Forty-one (65.1%) antireflux procedures were performed, including 21 reconstitutions of the angle of His (33.3%), nine (14.3%) anterior fundoplications, and 11 (17.5%) posterior fundoplications. All patients demonstrated preoperative dysphagia. Postoperative dysphagia was present in 23 of 63 (36.5%). Of these, 13 (56.5%) patients had an antireflux procedure, whereas 28 of 40 who had an antireflux procedure (70%) had no postoperative dysphagia (P = 0.28). Thirty-nine of 62 (62.9%) had symptomatic esophageal reflux preoperatively, and postoperative reflux was reported in 22 of 63 (34.9%). Reflux was present in 72.7 per cent of patients who had an antireflux procedure versus 61 per cent of those without the addition of an antireflux procedure (P = 0.415). However, HM independently improved reflux status regardless of whether an antireflux procedure was performed using the exact McNemar's test (P = 0.0014). Although the performance of an antireflux procedure did not appear to alter the reflux status after HM for achalasia, neither was it associated with postoperative dysphagia. More importantly, HM was independently associated with an improvement of reflux symptoms regardless of the type of antireflux procedure performed or whether one was used or not.

HP08�LONG TERM FOLLOW-UP OF LAPAROSCOPIC HELLER MYOTOMY FOR ACHALASIA

2009 ◽  
Vol 79 ◽  
pp. A40-A40
Author(s):  
K. M. Heggie ◽  
C. Pilgrim ◽  
W. Brown ◽  
J. Choi ◽  
A. Smith ◽  
...  
Keyword(s):  
Heller Myotomy ◽  
Laparoscopic Heller Myotomy ◽  
Long Term Follow Up

THE SURGICAL TREATMENT OF ACHALASIA ON LAPAROSCOPIC HELLER MYOTOMY WITH DOR ANTIREFLUX PROCEDURE AT HUE CENTRAL HOSPITAL

2020 ◽  
pp. 97-102
Author(s):  
Dung Phan Dinh Tuan ◽  
Hung Dang Ngoc ◽  
Loc Le
Keyword(s):  
Heller Myotomy ◽  
Clinical Symptoms ◽  
Laparoscopic Heller Myotomy ◽  
Antireflux Procedure ◽  
Pneumatic Dilation ◽  
Motor Disorder ◽  
Eckardt Score ◽  
Esophageal Sphincter ◽  
Prospective Analyses

Background: Achalasia is a primary motor disorder of the esophagus characterized by insufficient lower esophageal sphincter relaxation and loss of esophageal peristalsis. Diagnosis is confirmed by clinical symptoms, endoscopic, radiographic and manometric. Although pneumatic dilation has a role in the treatment of achalasia, laparoscopic Heller myotomy is considered by many experts as the best treatment modality for most patients with newly diagnosed achalasia. Objective: To evaluate the efficacy and safety of laparoscopic Heller myotomy with Dor antireflux procedure. Patients and Methods: Prospective analyses of the patients of achalasia undergoing laparoscopic Heller myotomy with Dor antireflux procedure from 01/2012 to 06/2020. We evaluated the data according to outcome measures, characteristics and treatment results of achalasia after laparoscopic Heller myotomy with Dor antireflux procedure. Results: We found 11 patients with achalasia were diagnosed and treated by laparoscopic. 100% of the patients have dysphagia, weight loss; 81.8% have chest pain and regurgitation. Mean operative duration was 148 ± 21 minutes. There was no complications had found in our patients. Follow-up after 3 - 6 months by Eckardt score show that 90.9% had a good result, 01 patient with persistent symtomps (Eckardt score > 3) had to undergo a pneumatic dilation. Conclusion: The results of the laparoscopic Heller myotomy with Dor antireflux procedure were safe and effective. Keywwords: Achalasia, laparoscopic Heller myotomy, Dor antireflux procedure

Sign in / Sign up

Export Citation Format

Share Document