Laparoscopic treatment for esophageal achalasia: experience at a single center

Agrusa, Antonino and Romano, Giorgio and Bonventre, S. and Salamone, G. and Cocorullo, G. and Gulotta, Gaspare (2013) Laparoscopic treatment for esophageal achalasia: experience at a single center. Il giornale di chirurgia, 34 (7/8). pp. 220-223. ISSN 1971-145X

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Background. Achalasia is a not frequent esophageal disorder characterized by the absence of esophageal peristalsis and incomplete relaxation of the lower esophageal sphincter (LES). Its cause is unknown. The aim of treatment is to improve the symptoms. We report the results of the treatment of this condition achieved in one center. Patients and methods. We conducted a retrospective study of patients with esophageal achalasia. In the period 2010-2012 we observed 64 patients, of whom 19 were referred for medical treatment. Three of the remaining patients underwent botulinum toxin injection, 17 underwent multiple endoscopic dilation procedures and 25 underwent laparoscopic surgery. Results. There were no complications in the group undergoing endoscopic therapy, but symptom remission was only temporary. Patients undergoing surgery showed a significant improvement in symptoms and no recurrence throughout the follow-up period, that is still ongoing (3 years). There were no major complications in any case and no morbidity or mortality. Conclusions. Surgical treatment of esophageal achalasia with laparoscopic Heller myotomy and Dor fundoplication gives the best and longest-lasting results in suitably selected patients. The extension of the myotomy and reduction in LES pressure are the most important parameters to achieve a good result.

Item Type: Article
Additional Information: Laparoscopy, Heller myotomy, Intraoperative manometry
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User: Nadia Del Gobbo
Date Deposited: 13 Sep 2019 08:24
Last Modified: 13 Sep 2019 08:24

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