Effects of Preoperative Endoscopic Pneumatic Balloon Dilatation on Postoperative Achalasia Symptoms After Heller Esophageal Myotomy Plus Dor Fundoplication

Overview

Journal Turk J Gastroenterol

Publisher Aves

Specialty Gastroenterology

Date 2018 Sep 28

PMID 30260775

Citations 1

Authors

Volkan Oter

Erdal Birol Bostanci

Kerem Karaman

Fatih Sumer

Ilter Ozer

Affiliations

Soon will be listed here.

Abstract

Background/aims: Currently, forceful endoscopic pneumatic balloon dilatation (PBD), laparoscopic Heller myotomy (LHM) with or without an anti-reflux procedure, and peroral endoscopic myotomy are the preferred treatment options for achalasia. The aim of the present study was to retrospectively compare postoperative outcomes after LHM plus Dor fundoplication (DF) between patients who underwent prior endoscopic balloon dilatation and those who did not.

Materials And Methods: Sixty-five patients who underwent HM+DF between January 2008 and December 2016 were retrospectively analyzed. Of these, 45 had a history of endoscopic PBD. Pre- and postoperative achalasia symptoms, including weight loss, dysphagia, heartburn, and regurgitation, were evaluated using the Eckardt score.

Results: Fifty (76.9%) patients underwent laparoscopic surgery and 15 (23.1%) underwent open surgery. When patients were compared according to the presence of preoperative endoscopic PBD, no significant difference were observed in terms of age, sex, preoperative lower esophageal sphincter pressure, operation time, hospitalization period, and follow-up period (p>0.05). The mean Eckardt score at the first postoperative year was significantly lower than the preoperative Eckardt score (4.51±1.8 vs. 0.52±0.7; p<0.001). In contrast, no significant difference was found between patients with and without previous PBD on the pre- and postoperative Eckardt scores (p=0.43).

Conclusion: HM+DF is an effective procedure in relieving achalasia symptoms as a first-line therapy as well as in individuals unresponsive to repeated endoscopic PBDs.

Citing Articles

Updated Systematic Review of Achalasia, with a Focus on POEM Therapy.

Cappell M, Stavropoulos S, Friedel D Dig Dis Sci. 2019; 65(1):38-65.

PMID: 31451984 DOI: 10.1007/s10620-019-05784-3.

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