Long-term outcome of esophageal myotomy for achalasia

• Published in: World journal of gastroenterology : WJG 2004-01, Vol.10 (2), p.287-291
• Main Authors: Liu, Jun-Feng, Zhang, Jun, Tian, Zi-Qiang, Wang, Qi-Zhang, Li, Bao-Qing, Wang, Fu-Shun, Cao, Fu-Min, Zhang, Yue-Feng, Li, Yong, Fan, Zhao, Han, Jian-Jing, Liu, Hui
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Brief Reports; Child; China; Digestive System Surgical Procedures; Esophageal Achalasia - diagnostic imaging; Esophageal Achalasia - surgery; Esophagoscopy; Female; Follow-Up Studies; Heller＇s手术; Humans; Hydrogen-Ion Concentration; Male; Manometry; Middle Aged; Radionuclide Imaging; Treatment Outcome; 手术治疗; 肌弛缓不能; 远期疗效; 食道肌切开术
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v10.i2.287

AIM:Modified Heller's myotomy is still the first choice for achalasia and the assessment of surgical outcomes is usually made based on the subjective sensation of patients.This study was to objectively assess the long-term outcomes of esophageal myotomy for achalasia using esophageal manometry, 24-hour pH monitoring,esophageal scintigraphy and fiberoptic esophagoscopy.METHODS:From February 1979 to October 2000, 176 patients with achalasia underwent modified Heller's myotomy, including esophageal myotomy alone in 146 patients, myotomy in combination with Gallone or Dor antirefiux procedure in 22 and 8 patients, respectively. Clinical score,pressure of the lower esophageal sphincter (LES),esophageal clearance rate and gastroesophageal reflux were determined before and i to 22 years after surgery.RESULTS: After a median follow-up of 14 years, 84.5% of patients had a good or excellent relief of symptoms,and clinical scores as well as resting pressures of the esophageal body and LES were reduced compared with preoperative values (P