Laparoscopie Heller-Dor for primary esophagus achalasia. Outcomes in 173 patients

Riccardo Rosati, Uberto Fumagalli Romano, Martina Ceolin, Simonetta Massaron, Alberto Peracchia

Research output: Contribution to journalArticle

Abstract

Aim: Laparoscopic Heller myotomy combined with anterior (Dor) fundoplication is the most widely-used surgical procedure for treating esophageal achalasia in Europe Material of Study: From November 1992 through May 2010 we performed laparoscopic Heller-Dor on 173 patients Results: Conversion to laparotomy was required in three cases (1.7%) at the beginning of the experience (for mucosal) perforation which was the most frequent intraoperative complication, managed laparoscopically with the increasing experience. Five (2.9%) cases had minor postoperative complications. Clinical results were satisfactory in 99.4% of cases. One patient (0.6%) had severe persistent dysphagia. Mean esophageal diameter decreased from 50 mm ± 12 (range 20-90) to 25 mm ± 7 (range 15-80). Lower esophageal sphincter pressure decreased from 32 mmHg (median, range 10-93) pre-operatively to 11 mmHg (median, range 5-21) at one year follow up and residual pressure from 12 mmHg (median, range 3-30) to 4 mmHg (median, range 1-8). Impedance and pH monitoring showed normal levels in 39147 (83%) patients who agreed to testing. Conclusion: The good outcomes of this experience, in part due to careful adherence to technical aspects of the operation, confirm that the laparoscopic Heller-Dor is the gold standard surgical treatment for esophageal achalasia.

Original languageEnglish
Pages (from-to)515-519
Number of pages5
JournalAnnali Italiani di Chirurgia
Volume84
Issue number5
Publication statusPublished - 2013

Keywords

  • Achalasia
  • Dor fundoplication
  • Laparoscope Heller myotomy

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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    Rosati, R., Romano, U. F., Ceolin, M., Massaron, S., & Peracchia, A. (2013). Laparoscopie Heller-Dor for primary esophagus achalasia. Outcomes in 173 patients. Annali Italiani di Chirurgia, 84(5), 515-519.