Laparoscopic Heller's Cardiomyotomy and Dor's Fundoplication for Esophageal Achalasia
- 1 August 1996
- journal article
- research article
- Published by Mary Ann Liebert Inc in Journal of Laparoendoscopic Surgery
- Vol. 6 (4) , 253-258
- https://doi.org/10.1089/lps.1996.6.253
Abstract
The study's aim was to assess the functional results of laparoscopically performed Heller's myotomy and Dor's fundoplication in our first few cases of esophageal achalasia. Four male patients (mean age: 61 years) with long-standing symptoms of achalasia (documented on esophagogram and esophageal manometry) and not responding to several sessions of pneumatic dilatation, had laparoscopic Heller's myotomy and Dor's fundoplication. Myotomy was facilitated by distending the esophagus. The mean duration of the operation was 99 min. The third patient developed a leak from the exposed esophageal mucosa on the 5th postoperative day while at home. The leak was attributed to late desloughing of a mucosal burn, and was sealed spontaneously 15 days later after drainage. The remaining three patients were discharged after resuming diet within the first 2 postoperative days. By 1 year postoperatively, dysphagia was abolished in all cases, and there were no gastroesophageal reflux symptoms. The esophagogram showed no reflux, which was also confirmed on ambulatory 24-h esophageal pH measurement. On manometry, lower esophageal sphincter (LES) pressure dropped significantly postoperatively (preop: 56 ± 7 SD mm Hg, postop: 5 ± 1 SD mm Hg, p < 0.001). In conclusion, laparoscopic Heller's myotomy with Dor's fundoplication for esophageal achalasia is a feasible procedure, offering clinical and laboratory results similar to the open approach, but with better patient tolerance.Keywords
This publication has 12 references indexed in Scilit:
- Heller laparoscopic cardiomyotomy with antireflux anterior fundoplication (Dor) in the treatment of esophageal achalasiaSurgical Endoscopy, 1993
- Predictors of outcome in patients with achalasia treated by pneumatic dilationGastroenterology, 1992
- Medical treatment of esophageal achalasiaDigestive Diseases and Sciences, 1991
- Surgery or pneumatic dilatation for achalasia: A head-to-head comparison. Now are all the questions answered?Gastroenterology, 1989
- Heller's myotomy for achalasia: Is an added anti-reflux procedure necessary?British Journal of Surgery, 1987
- Esophageal motor abnormalities in gastroesophageal reflux and the effects of fundoplicationGastroenterology, 1986
- To dilate or to operate? That is the question.Gut, 1983
- A prospective randomized study comparing forceful dilatation and esophagomyotomy in patients with achalasia of the esophagusGastroenterology, 1981
- Esophagomyotomy versus Forceful Dilation for Achalasia of the Esophagus: Results in 899 PatientsThe Annals of Thoracic Surgery, 1979
- Achalasia, Diffuse Esophageal Spasm, and Related Motility DisordersGastroenterology, 1979