Paper presentedLong-term results of laparoscopic Heller myotomy with partial fundoplication for the treatment of achalasia
Section snippets
Patient population
All consecutive patients with achalasia who underwent minimally invasive surgical treatment by a single surgeon (R.A.H.) between January 1991 and December 2001 were included in this study. There were a total of 75 patients, 34 men and 41 women, with a median age of 47 years (range 15 to 80). The medical record of all individuals was reviewed for demographics, symptoms, surgical technique, outcome, and complications. Table 1 shows demographic and clinical data of the study cohort.
Surgical procedure
During the
Results of surgery
There was no mortality and no conversion to open surgery was necessary. In 3 cases, early in our experience, an inadvertent mucosal perforation occurred, which was laparoscopically oversewn without adverse consequence in all cases. No surgical complications were observed and mean hospitalization was 1.8 days (range 1 to 6, SD ± 1.1).
A total of 47 replies (64%) were obtained. Three patients (6%) died of unrelated causes during the follow-up period. A total of 44 questionnaires could be
Comments
This retrospective study demonstrates that minimal invasive surgery for achalasia is effective long-term therapy, but many of the patients required additional treatment [26]. The need for further therapy is a reflection of the fact that few patients will regain normal esophageal body function and many will have persistent dysphagia or heartburn. Symptoms of achalasia have usually been present for many years before surgery, resulting in a destruction of esophageal body function [1], [3].
Despite
Acknowledgment
Dr. Bonatti was sponsored by the Detiger Fellowship.
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