Predictors of Long-term Outcome After Laparoscopic Esophagomyotomy and Dor Fundoplication for Achalasia

Abstract

Objective: To identify predictors of long-term outcome of laparoscopic Heller myotomy for achalasia, including predictors of heartburn and recurrent dysphagia, which occasionally develop postoperatively. Design: Retrospective review using interviews of patients. Setting: Academic university hospital. Patients: One hundred sixty-five patients with achalasia who underwent a laparoscopic esophagomyotomy and Dor fundoplication. Main Outcome Measures: Dysphagia and heartburn before and after the operation were assessed on a 4-point Likert scale, as were postoperative dilations, reoperations, and antacid use. Potential predictors were age, race, sex, body mass index, weight loss, duration of symptoms, manometry findings, esophageal diameter, previous treatment, and operative technique. Results: Follow-up averaged 62 (range, 1-174) months. Dysphagia frequency was once a week or less in 128 pa

Training in peroral endoscopic myotomy (POEM) for esophageal achalasia

“…To evaluate the treatment response to POEM, there are different validating scoring systems 11,30. A multitude of symptoms have been queried, with dysphagia the main symptom in all studies.…”

Laparoscopic management of achalasia cardia

“…Carter JT et al studied 165 patients for mean 62 months and there was significant relief of heart burn postoperatively. 7 Yamamura MS et al also had very significant improvement in heart burn in a study of 24 patients with 16.5 months mean follow up. 13 Decker G et al studied 73 patients who had heart burn and postoperative follow up for median 30 months there was 88% patients with complete relief of heart burn and better gastro intestinal quality of life.…”

“…6 Carter JD et al had slightly more male patients as compared to female with average age incidence of 49 years. 7 Zaninotto G et al had slightly higher female incidence than male with mean age of presentation was 41 years. 8 Decker G et al, all these studies had mean age of disease presentation nearer to the present study.…”

“…7 It was found that at the end of 3 months 78% of patients had complete relief of dysphagia and at the end of 6 months it was found that 89% of patients were free from dysphagia.…”

Esophageal Achalasia: Predictive Value of Preoperative Resting Pressure of LES Correlated with Type of Fundoplication

“…Achalasia is a primary disorder of esophageal motility with consequent loss of esophageal peristalsis and impaired or failed relaxation of the lower esophageal sphincter (LES) during swallowing [1,3].…”