R Ackroyd1, D I Watson, P G Devitt, G G Jamieson. 1. Department of Surgery, Royal Adelaide Hospital, University of Adelaide, North Terrace, Adelaide, South Australia 5000, Australia.
Abstract
BACKGROUND: Although surgical myotomy is considered the gold standard, many different treatments have been advocated for achalasia. There are now a number of reports of cardiomyotomy being performed laparoscopically. METHODS: This is a prospective study of 82 patients (47 male and 35 female; median age, 47 years) who underwent laparoscopic cardiomyotomy and anterior partial fundoplication for achalasia. RESULTS: Four of the 82 procedures required conversion to open surgery, all during the early stages of the series, and two required early reoperation for a postoperative problem. The median operating time was 80 min (range, 32-210). the median hospital stay was 3 days (range, 2-18), and normal physical activity was resumed after a median of 2 weeks (range, 3 days to 12 weeks). Follow-up ranged up to 8 years (median, 2). Postoperatively, symptoms of dysphagia (to both solids and liquids), heartburn, odynophagia, chest pain, regurgitation, and cough were significantly reduced in all patients. The median overall satisfaction score (graded from 0 to 10, with 10 representing total satisfaction) was 9 (range, 0-10), and 90% of patients were highly satisfied with the surgical outcome. CONCLUSION: Laparoscopic cardiomyotomy with anterior partial fundoplication achieves excellent symptomatic relief for patients with achalasia, and it can be performed with minimal morbidity.
BACKGROUND: Although surgical myotomy is considered the gold standard, many different treatments have been advocated for achalasia. There are now a number of reports of cardiomyotomy being performed laparoscopically. METHODS: This is a prospective study of 82 patients (47 male and 35 female; median age, 47 years) who underwent laparoscopic cardiomyotomy and anterior partial fundoplication for achalasia. RESULTS: Four of the 82 procedures required conversion to open surgery, all during the early stages of the series, and two required early reoperation for a postoperative problem. The median operating time was 80 min (range, 32-210). the median hospital stay was 3 days (range, 2-18), and normal physical activity was resumed after a median of 2 weeks (range, 3 days to 12 weeks). Follow-up ranged up to 8 years (median, 2). Postoperatively, symptoms of dysphagia (to both solids and liquids), heartburn, odynophagia, chest pain, regurgitation, and cough were significantly reduced in all patients. The median overall satisfaction score (graded from 0 to 10, with 10 representing total satisfaction) was 9 (range, 0-10), and 90% of patients were highly satisfied with the surgical outcome. CONCLUSION: Laparoscopic cardiomyotomy with anterior partial fundoplication achieves excellent symptomatic relief for patients with achalasia, and it can be performed with minimal morbidity.
Authors: Aleksandar Petar Simić; Nebojsa S Radovanović; Ognjan M Skrobić; Zoran J Raznatović; Predrag M Pesko Journal: J Gastrointest Surg Date: 2009-12-22 Impact factor: 3.452
Authors: Gianluca Rossetti; Luigi Brusciano; Giuseppe Amato; Vincenzo Maffettone; Vincenzo Napolitano; Gianluca Russo; Domenico Izzo; Federica Russo; Francesco Pizza; Gianmattia Del Genio; Alberto Del Genio Journal: Ann Surg Date: 2005-04 Impact factor: 12.969
Authors: G Ramacciato; F A D'Angelo; P Aurello; M Del Gaudio; G Varotti; P Mercantini; R Bellagamba; G Ercolani Journal: World J Gastroenterol Date: 2005-03-14 Impact factor: 5.742
Authors: Silvana Perretta; Piero M Fisichella; Carlos Galvani; Maria V Gorodner; Lawrence W Way; Marco G Patti Journal: J Gastrointest Surg Date: 2003 Jul-Aug Impact factor: 3.452