Laparoscopic cardiomyotomy and Dor's fundoplication for the treatment of achalasia: at least two-year follow-up
Tayfun Karahasanoğlu1, İsmail Hamzaoğlu1, Bilgi Baca1, Ahmet Dobrucalı2
1İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Genel Cerrahi AD, İSTANBUL
2İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Gastroenteroloji Bilim Dalı, İSTANBUL
Purpose: The aim of this study was to assess our results of laparoscopic Heller myotomy and Dor's fundoplication in patients with achalasia.
Materials and Methods: Twelve consecutive patients who underwent laparoscopic Heller myotomy and Dor's fundoplication for achalasia by the same surgical team were retrospectively evaluated on a prospective database. Minimum follow-up was two years. Patients were assessed with symptom scoring scale and manometry and/or pH monitorization if clinically indicated.
Results: Myotomy with fundoplication was completed laparoscopically in all patients whereas a mucosal esophagus perforation occurred in one patient and it was repaired laparoscopically. There was no mortality and none of the patients required reoperation. Mean follow-up was 44 (24-77) months. Permanent healing of the disease was observed in all patients, except in one whose disphagia complaint was not sufficiently resolved in the early postoperative period. Postoperatively, gastroesophageal reflux was observed in two patients (16%) whose symptoms were taken under the control with medical treatment. Patient satisfaction rate was 91%.
Conclusion: Laparoscopic Heller myotomy and Dor's fundoplication is reliable and effective procedure for the treatment of achalasia. Symptom-free survival was permanent in the patients who were symptomatically healed in the early postoperative period.
Keywords: Achalasia, Heller's cardiomyotomy, Dor's fundoplication, laparoscopy