Very Long-term Objective Evaluation of Heller Myotomy Plus Posterior Partial Fundoplication in Patients With Achalasia of the Cardia

Ortiz, A. S.; Haro, Luisa F. Martínez de; Parrilla, Pascual; Lage, Ana Cristina; Perez, Domingo; Munítiz, Vicente; Ruiz, David; Molina, Joaquín

doi:10.1097/sla.0b013e318159d7dd

Cited by 69 publications

(42 citation statements)

References 42 publications

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“…As with other reports, [11][12][13]15 we identified some deterioration in outcome at later follow-up, although most symptomatic failures occurred early. Of the 26 patients who developed recurrent dysphagia, 12 (46%) developed symptoms within 1 year of surgery, and 20 (77%) of the recurrences were within 3 years.…”

Section: Discussionsupporting

confidence: 71%

Laparoscopic Cardiomyotomy for Achalasia: Clinical Outcomes Beyond 5 Years

Chen

Bessell

Chew

et al. 2010

Journal of Gastrointestinal Surgery

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Section: Discussionsupporting

confidence: 71%

Laparoscopic Cardiomyotomy for Achalasia: Clinical Outcomes Beyond 5 Years

Chen

Bessell

Chew

et al. 2010

Journal of Gastrointestinal Surgery

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“…Ortiz et al [26] evaluated pH results in 136 patients with a median 6-year follow-up after open myotomy plus Toupet FP and abnormal pH results were found in 19 patients (14%) overall; abnormal acid exposure increased over the course of follow-up from 8.1% at 1 year to 18.5% at 5 years and 23.7% at 10 years. In Swanstrom's series [21], 48 of 120 patients who underwent laparoscopic Heller myotomy plus Toupet FP underwent pH testing 6-12 months postop; pathologic reflux was seen in 33.3%.…”

Section: Discussionmentioning

confidence: 96%

Laparoscopic Dor versus Toupet fundoplication following Heller myotomy for achalasia: results of a multicenter, prospective, randomized-controlled trial

Soper²,

et al. 2011

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“…The standard "open" myotomy can be performed using either an abdominal or, more commonly, a thoracic approach [42,43] . More recently, laparoscopic and thoracoscopic techniques have been used to perform myotomy [39,[44][45][46] .…”

Section: Surgical Myotomymentioning

confidence: 99%

Achalasia: A review of Western and Iranian experiences

Mikaeli¹,

Islami²,

Malekzadeh³

2009

WJG

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Achalasia is a primary motor disorder of the eso phagus, in which esophageal emptying is impaired. Diagnosis of achalasia is based on clinical findings. The diagnosis is confirmed by radiographic, endoscopic, and manometric evaluations. Several treatments for achalasia have been introduced. We searched the PubMed Database for original articles and meta analyses about achalasia to summarize the current knowledge regarding this disease, with particular focus on different procedures that are used for treatment of achalasia. We also report the Iranian experience of treatment of this disease, since it could be considered as a model for mediumresource countries. Myotomy, particularly laparoscopic myotomy with fundoplication, i s t h e m o s t e ffe c t i ve t re a t m e n t fo r a c h a l a s i a . Compared to other treatments, however, the initial cost of myotomy is usually higher and the recovery period is longer. When performing myotomy is not indicated or not possible, graded pneumatic dilation with slow rate of balloon inflation seems to be an effective and safe initial alternative. Injection of botulinum toxin into the lower esophageal sphincter before pneumatic dilation may increase remission rates. However, this needs to be confirmed in further studies. Due to lack of adequate information regarding the role of expandable stents in the treatment of achalasia, insertion of stents does not currently seem to be a recommended treatment. In summary, laparoscopic myotomy can be considered as the procedure of choice for treatment of achalasia. Graded pneumatic dilation is an effective alternative when the performance of myotomy is not possible for any reason.

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Very Long-term Objective Evaluation of Heller Myotomy Plus Posterior Partial Fundoplication in Patients With Achalasia of the Cardia

Abstract: Results after Heller myotomy plus posterior partial fundoplication deteriorate with time, although we achieved a 75% of satisfactory results after>15 years of follow-up. Our study highlights the importance of life long follow-up and the objective assessment of the results.

Cited by 69 publications

References 42 publications

Laparoscopic Cardiomyotomy for Achalasia: Clinical Outcomes Beyond 5 Years

Laparoscopic Cardiomyotomy for Achalasia: Clinical Outcomes Beyond 5 Years

Laparoscopic Dor versus Toupet fundoplication following Heller myotomy for achalasia: results of a multicenter, prospective, randomized-controlled trial

Achalasia: A review of Western and Iranian experiences

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