Long-term outcome for achalasia in patients who underwent laparoscopic Heller myotomy with Dor fundoplication

Abstract

Introduction: Achalasia is a rare esophageal motility disorder that can require surgical intervention in some cases. This retrospective cross-sectional study aims to evaluate the clinical symptoms of patients with advanced achalasia who underwent laparoscopic Heller myotomy (LHM) and Dor fundoplication. Materials and Methods: The study included 86 patients (38 men, 48 women) diagnosed with achalasia between 2010 and 2020, of which 20 patients with advanced achalasia underwent LHM and Dor fundoplication. The median follow-up time was 48 months. Results: The study found that LHM and Dor fundoplication surgery improved dysphagia in 12 patients, with four patients showing improvement in solid food dysphagia and two patients showing improvement in semi-solid dysphagia. Nocturnal cough and slow emptying sensation also improved in 16 cases. Additionally, barium stasis decreased significantly in 14 patients. However, two patients who underwent esophagectomy had hospital mortality. Conclusion: This study highlights the effectiveness of LHM and Dor fundoplication in reducing dysphagia, nocturnal coughing, regurgitation, and other obstructive symptoms in patients with advanced achalasia. However, the study also underscores the potential risks associated with esophagectomy, suggesting that surgical treatment for achalasia should be carefully considered on a case-by-case basis.

Keywords

• achalasia
• dysphagia
• heller myotomy
• fundoplication
• gastroesophageal reflux