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Laparoscopic Heller-Dor operation for patients with achalasia.

Abstract：

BACKGROUND:Laparoscopic Heller cardiomyotomy and Dor fundoplication is the surgical procedure of choice for esophageal achalasia. The aim of this study was to investigate the clinical outcome of laparoscopic Heller-Dor procedure in our initial series of 25 patients with achalasia. METHODS:Between October 2003 and January 2006, a total of 25 patients with achalasia underwent laparoscopic Heller-Dor operation. Among them, 9 were male and 16 were female with an average age of (41.5 +/- 5.1) years (21-66). All the patients received upper gastrointestinal series (barium swallow), esophagogastroscopy, esophageal manometry to exclude esophageal carcinoma and to confirm the diagnosis, and 21 patients also had 24-hour ambulatory pH studies. All the patients were operated by laparoscopic modified Heller's myotomy with Dor fundoplication. In addition, 2 of them had combined laparoscopic cholecystectomy + excision of hepatic hemangioma and laparoscopic cholecystectomy, respectively. RESULTS:The average operating time was (110.6 +/- 12.9) minutes (range, 60-180), operative blood loss averaged (18.6 +/- 7.1) ml (5-50), the median time to oral feeding was (1.6 +/- 0.4) days (1-4) and the median hospital stay was (12.6 +/- 1.2) days (10-20). There was no conversion to open surgery. Intraoperative mucosal perforation was encountered in six patients and was repaired in all of them by laparoscopic suture. All the patients had an uneventful recovery without postoperative complication. After a median follow-up of (10.6 +/- 7.2) months (1-27), 24 patients were asymptomatic and 1 had mild postoperative dysphagia. CONCLUSIONS:Laparoscopic Heller-Dor operation had the advantages of reduced compromise of the cardiopulmonary function, with less disruption of the supporting structures (phrenoesophageal membrane) of the antireflux mechanism, requiring simpler general anesthesia and providing excellent exposure permitting an easy fundoplication, less pain and reduced morbidity, shorter hospitalization and faster convalescence.

journal_name

Chin Med J (Engl)

journal_title

Chinese medical journal

authors

Wang QS,Liu L,Dong L,Shen ZL,Zhou DH,Hu CX

keywords:

subject

Has Abstract

pub_date

2006-03-20 00:00:00

pages

443-7; discussion 447-8

issue

eissn

0366-6999

issn

2542-5641

journal_volume

119

pub_type

杂志文章

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Laparoscopic Heller-Dor operation for patients with achalasia.