Laparoscopic Heller myotomy is equally efficient and safe in patients who had pre-myotomy endoscopic interventions when compared with those with no intervention.
Journal Title: Current Thoracic Surgery - Year 2017, Vol 2, Issue 1
Abstract
Background: Endoscopic treatment (ET) methods for achalasia such as balloon dilatation and botulinum toxin injection has good success for short and medium term management of achalasia. However some patients either need repeat attempts or referred to surgery. In this study we analyzed and compared the perioperative and disease specific quality of life outcomes of achalasia patients who either underwent surgery as a first line treatment and the ones who underwent ET method prior to surgery. Materials and Methods: The patients who underwent standard of care diagnostic workup and surgery for achalasia by the same surgical team between 2007 and 2014 were recorded in a prospective database. The patients who underwent surgery as a first line treatment (Group 1, n = 55) and the patients who underwent prior ET (Group 2, n = 33) were identified. Demographic data, peroperative complications, length of hospital stay, pre- and postoperative Eckardt scores were recorded and analyzed. Results: A total of 88 patients out of 105 were available for follow up with average follow up time of 61.9 ± 35.8 months. The mean age was 43.3 ± 15.6. Mean hospital stay was 2.3 ± 0.8 days and there was no mortality. Average duration of the effectivity of ET before myotomy was 5.7 ± 7.7 months. Peroperative complications not significantly accumulated in either group. Both groups showed comparable drop in Eckardt scores. Conclusions: Heller myotomy and Dor fundoplication is a safe and durable option for treatment of achalasia for both treatment naive patients and patients with previous repeated ET modalities.
Authors and Affiliations
Zeynep Bilgi, Adamu Issaka, Hasan Fevzi Batırel
Keywords
Related Articles
- EP ID EP292643
- DOI 10.26663/cts.2017.0001
- Views 115
- Downloads 0
Diagnosis and treatment of spontaneous pneumomediastinum is not complicated
Background: Spontaneous pneumomediastinum is a rare and usually benign finding in young male patient without a history. When subcutaneous emphysema occurs, the patient and medical physicians feel uneasy about the view of...
Is chest x-ray necessary after thoracentesis? Bilateral pneumothorax
Currently, thoracentesis is used to drain accumulated fluids in chest cavity such as; pleural effusion, hemothorax and chylothorax and also for diagnosis and treatment of diseases. It is a simple and reliable treatment m...
Primary malignant mediastinal germ cell tumor in childhood
Primary malignant mediastinal germ cell tumors are rare in childhood. Despite the metastasis to lung, liver, brain and bone is possible but sternal metastasis is unusual. Both tumor and its metastases treated with surgic...
Diagnosis and treatment approaches of the lung hydatid cysts in childhood
Background: Cyst hydatid is an important health problem in childhood and adult age group. We aimed to present the management of childhood cyst hydatid cases treated with surgery. Materials and Methods: The records of 3...
Comparison of the outcomes of the implanted subcutaneous ports in cancer patients: six-years single center experience
Background: The preferred site of venous access ranges from deep veins (internal jugular or subclavian veins) to superficial veins (external jugular, anterior jugular, and upper limb veins). The aim of the study is to e...