BACKGROUND: We show the experience of 6 years in laparoscopic surgical therapy of esophageal achalasia, performing of the Heller-Dor or Heller-Toupet operation, with particular regard to the technical aspect. METHODS: One hundred and ten laparoscopic interventions were done between November 1995 and December 2001. We studied operative time in hiatus approach, esophagocardiomyotomy, transoperative endoscopy, and anti-reflux procedure. We also analyzed the relation between complications and clinical evolution of disease with clinical stage. RESULTS: The mean surgical time of the intervention is 138 min, and it is significantly increased by transoperative endoscopic control; conversion to open surgery was not necessary. Clinical results are classified as excellent in 103 patients. Morbidity was 6%. CONCLUSION: This surgical procedure is a first line in the treatment of esophageal achalasia. It is necessary to have special care in early diagnostic cases to avoid electrosurgical injury.
BACKGROUND: We show the experience of 6 years in laparoscopic surgical therapy of esophageal achalasia, performing of the Heller-Dor or Heller-Toupet operation, with particular regard to the technical aspect. METHODS: One hundred and ten laparoscopic interventions were done between November 1995 and December 2001. We studied operative time in hiatus approach, esophagocardiomyotomy, transoperative endoscopy, and anti-reflux procedure. We also analyzed the relation between complications and clinical evolution of disease with clinical stage. RESULTS: The mean surgical time of the intervention is 138 min, and it is significantly increased by transoperative endoscopic control; conversion to open surgery was not necessary. Clinical results are classified as excellent in 103 patients. Morbidity was 6%. CONCLUSION: This surgical procedure is a first line in the treatment of esophageal achalasia. It is necessary to have special care in early diagnostic cases to avoid electrosurgical injury.
Authors: N Omura; H Kashiwagi; Y Ishibashi; F Yano; K Tsuboi; N Kawasaki; Y Suzuki; K Yanaga Journal: Surg Endosc Date: 2005-11-21 Impact factor: 4.584