The Outcome of Laparoscopic Surgery with and Without Short Gastric Vessel Division for Achalasia

Overview

Journal Int Surg

Specialty General Surgery

Date 2014 Dec 2

PMID 25437598

Authors

Yasunori Akutsu

Naoyuki Hanari

Tsuguaki Kono

Masaya Uesato

Isamu Hoshino

Kentaro Murakami

Toshiyuki Natsume

Yuka Isozaki

Naoki Akanuma

Takeshi Toyozumi

Hiroshi Suito

Hisahiro Matsubara

Affiliations

Soon will be listed here.

Abstract

Short gastric vessel division (SGVD) has been performed as a part of fundoplication for achalasia. However, whether or not SGVD is necessary is still unknown. Forty-six patients with achalasia who underwent a laparoscopic surgery with or without SGVD were analyzed. A questionnaire was administered to assess the postoperative improvement. Regarding improvement of dysphagia and postoperative reflux, there were no significant differences between SGVD (+) group and SGVD (-) group (P = 0.588 and P = 0.686, respectively). Nineteen patients (95%) in the SGVD (+) group and 24 (92%) in the SGVD (-) group answered that the surgery was satisfactory (P = 0.756). In the SGVD (+) group, the pre- and postsurgical body weight increase was +7.3%. In the SGVD (-) group, it was 8.2%. There was no significant difference of body weight increase between the 2 groups (P = 0.354). SGVD is not always required in laparoscopic surgery for achalasia.

References

Chrysos E, Tzortzinis A, Tsiaoussis J, Athanasakis H, Vasssilakis J, Xynos E . Prospective randomized trial comparing Nissen to Nissen-Rossetti technique for laparoscopic fundoplication. Am J Surg. 2001; 182(3):215-21. DOI: 10.1016/s0002-9610(01)00695-x. View

Sasaki A, Obuchi T, Nakajima J, Kimura Y, Koeda K, Wakabayashi G . Laparoscopic Heller myotomy with Dor fundoplication for achalasia: long-term outcomes and effect on chest pain. Dis Esophagus. 2009; 23(4):284-9. DOI: 10.1111/j.1442-2050.2009.01032.x. View

Omura N, Kashiwagi H, Yano F, Tsuboi K, Ishibashi Y, Hoshino M . Effect of laparoscopic esophagomyotomy on chest pain associated with achalasia and prediction of therapeutic outcomes. Surg Endosc. 2010; 25(4):1048-53. DOI: 10.1007/s00464-010-1314-5. View

Engstrom C, Jamieson G, Devitt P, Watson D . Meta-analysis of two randomized controlled trials to identify long-term symptoms after division of the short gastric vessels during Nissen fundoplication. Br J Surg. 2011; 98(8):1063-7. DOI: 10.1002/bjs.7563. View

Bello B, Herbella F, Patti M . Evolution of the minimally invasive treatment of esophageal achalasia. World J Surg. 2011; 35(7):1442-6. DOI: 10.1007/s00268-011-1027-5. View

Kroh M, El-Hayek K, Rosenblatt S, Chand B, Escobar P, Kaouk J . First human surgery with a novel single-port robotic system: cholecystectomy using the da Vinci Single-Site platform. Surg Endosc. 2011; 25(11):3566-73. DOI: 10.1007/s00464-011-1759-1. View

Catarci M, Gentileschi P, Papi C, Carrara A, Marrese R, Gaspari A . Evidence-based appraisal of antireflux fundoplication. Ann Surg. 2004; 239(3):325-37. PMC: 1356230. DOI: 10.1097/01.sla.0000114225.46280.fe. View

Dor J, Humbert P, PAOLI J, Miorclerc M, Aubert J . [Treatment of reflux by the so-called modified Heller-Nissen technic]. Presse Med (1893). 1967; 75(50):2563-5. View

Ancona E, Anselmino M, Zaninotto G, Costantini M, Rossi M, Bonavina L . Esophageal achalasia: laparoscopic versus conventional open Heller-Dor operation. Am J Surg. 1995; 170(3):265-70. DOI: 10.1016/s0002-9610(05)80012-1. View

10.

Watson D, Pike G, Baigrie R, Mathew G, Devitt P, Jamieson G . Prospective double-blind randomized trial of laparoscopic Nissen fundoplication with division and without division of short gastric vessels. Ann Surg. 1997; 226(5):642-52. PMC: 1191126. DOI: 10.1097/00000658-199711000-00009. View

11.

Bonatti H, Hinder R, Klocker J, Neuhauser B, Klaus A, Achem S . Long-term results of laparoscopic Heller myotomy with partial fundoplication for the treatment of achalasia. Am J Surg. 2005; 190(6):874-8. DOI: 10.1016/j.amjsurg.2005.08.012. View

12.

Csendes A, Braghetto I, Burdiles P, Korn O, Csendes P, Henriquez A . Very late results of esophagomyotomy for patients with achalasia: clinical, endoscopic, histologic, manometric, and acid reflux studies in 67 patients for a mean follow-up of 190 months. Ann Surg. 2006; 243(2):196-203. PMC: 1448918. DOI: 10.1097/01.sla.0000197469.12632.e0. View

13.

Tsuboi K, Omura N, Yano F, Kashiwagi H, Yanaga K . Results after laparoscopic Heller-Dor operation for esophageal achalasia in 100 consecutive patients. Dis Esophagus. 2008; 22(2):169-76. DOI: 10.1111/j.1442-2050.2008.00891.x. View

14.

Kosek V, Wykypiel H, Weiss H, Holler E, Wetscher G, Margreiter R . Division of the short gastric vessels during laparoscopic Nissen fundoplication: clinical and functional outcome during long-term follow-up in a prospectively randomized trial. Surg Endosc. 2008; 23(10):2208-13. DOI: 10.1007/s00464-008-0267-4. View

15.

OBoyle C, Watson D, Jamieson G, Myers J, Game P, Devitt P . Division of short gastric vessels at laparoscopic nissen fundoplication: a prospective double-blind randomized trial with 5-year follow-up. Ann Surg. 2002; 235(2):165-70. PMC: 1422409. DOI: 10.1097/00000658-200202000-00001. View