期刊
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
卷 19, 期 3, 页码 345-351出版社
SPRINGER
DOI: 10.1007/s00464-004-8941-7
关键词
achalasia; laparoscopic myotomy; Heller-Dor procedure; long-term follow-up; esophagus dysphagia
类别
Background: The aim of this study was to investigate the long-term clinical outcome of the laparoscopic Heller Dor procedure for esophageal achalasia. Methods: A total of 71 consecutive patients with a minimum 6 year follow-up were evaluated. These patients were seen at 1 and 6 months after the operation (at which time barium swallow, endoscopy, manometry, and pH monitoring were performed), and annually thereafter. A dedicated symptom score, that combined severity and frequency of symptoms was used. Results: The median symptom score decreased from 22 (range, 9-29) preoperatively to 4 (range, 0-16) at last follow-up, (p < 0.01). During the follow-up period, 13 patients suffered symptom recurrence; seven of them (54%) had already been diagnosed at the 1-year follow-up. All or these patients were treated with complementary pneumatic dilations. Overall, at a minimum of 6 years after the operation, 81.7% of the patients were satisfied with the treatment and were able to eat normally. Conclusions: The long-term outcome of laparoscopic surgical treatment of esophageal achalasia is only slightly affected by the length of the follow-up and most of the symptomatic failures occur in the early period after the operation.
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