Comparison between outcome after laparoscopic Heller's myotomy with Dor fundoplication in patients who had or had not undergone previous trials of endoscopic balloon dilatation for cardiac achalasia

Aim The aim of this study is to assess the effect of prior endoscopic balloon dilatation on the outcome of laparoscopic Heller's cardiomyotomy with Dor fundoplication (DF) for treatment of cardiac achalasia. Patients and methods This study was conducted over 20 patients who underwent laparoscop...

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Bibliographic Details
Published in:The Egyptian journal of surgery : official organ of the Egyptian Society of Surgeons = Majallat al-jirāhah al-Misrīyah 2021-10, Vol.40 (4), p.1215-1221
Main Authors: El Fiky, Khaled, El Akkad, Hisham Abdel, Mohamed, Mohamed, Gerges, Wadie
Format: Article
Language:English
Subjects:
Achalasia
Cardiac patients
Care and treatment
Laparoscopic surgery
Laparoscopy
Medical research
Medicine, Experimental
Patient outcomes
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Summary:Aim The aim of this study is to assess the effect of prior endoscopic balloon dilatation on the outcome of laparoscopic Heller's cardiomyotomy with Dor fundoplication (DF) for treatment of cardiac achalasia. Patients and methods This study was conducted over 20 patients who underwent laparoscopic Heller's cardiomyotomy with DF between January 2018 and December 2020 in Ain Shams University Hospitals. These patients were divided into two groups: the first group included patients who underwent Heller's cardiomyotomy with DF with previous once or multiple failed sessions of balloon dilatation [pneumatic balloon dilatation (PBD) group]. The second group included patients who underwent Heller's cardiomyotomy with DF without previous balloon dilatation (non-PBD group). Each patient was seen for follow-up after 6 months. Preoperative and postoperative achalasia symptoms, including weight loss, dysphagia, heartburn, and regurgitation, were evaluated using the Eckardt score. Results When patients were compared according to whether they underwent preoperative endoscopic PBD or not, there was no significant difference in terms of age, sex, preoperative lower esophageal sphincter pressure, hospitalization period, and complications. Operative time had a statistically significant difference between the two groups of patients. The mean Eckardt score measured at 6 months postoperative was significantly lower than the preoperative Eckardt score (0.55±0.69 vs. 4.45±1.36, P
ISSN:1110-1121
1687-7624
DOI:10.4103/ejs.ejs_193_21