Multicenter Evaluation with Eckardt Score of Laparoscopic Management with Heller Myotomy and Dor Fundoplication for Esophageal Achalasia in a Pediatric Population in Colombia

2021 ◽  
Vol 31 (2) ◽  
pp. 230-235
Author(s):  
Abraham Chams Anturi ◽  
Walter Romero Espitia ◽  
Angelo Loockhartt ◽  
María Daniela Moreno Villamizar ◽  
Mauricio Pedraza Ciro ◽  
...  
Keyword(s):  
Heller Myotomy ◽  
Pediatric Population ◽  
Esophageal Achalasia ◽  
Dor Fundoplication ◽  
Laparoscopic Management ◽  
Eckardt Score

Laparoscopic heller myotomy and dor fundoplication for esophageal achalasia in children

2001 ◽  
Vol 36 (8) ◽  
pp. 1248-1251 ◽  
Author(s):  
Marco G. Patti ◽  
Craig T. Albanese ◽  
George W. Holcomb ◽  
Daniela Molena ◽  
Piero M. Fisichella ◽  
...  
Keyword(s):  
Heller Myotomy ◽  
Esophageal Achalasia ◽  
Laparoscopic Heller Myotomy ◽  
Dor Fundoplication

O17 A PROPENSITY SCORE-MATCHED CASE-CONTROL STUDY TO COMPARE POEM AND LAPAROSCOPIC HELLER MYOTOMY IN THE TREATMENT OF ESOPHAGEAL ACHALASIA

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Costantini Andrea ◽  
Familiari Pietro ◽  
Costantini Mario ◽  
Salvador Renato ◽  
Valmasoni Michele ◽  
...  
Keyword(s):  
Propensity Score ◽  
Heller Myotomy ◽  
Ph Monitoring ◽  
Operation Time ◽  
High Volume ◽  
Esophageal Achalasia ◽  
Laparoscopic Heller Myotomy ◽  
Rank Test ◽  
Similar Reduction ◽  
Eckardt Score

Abstract Background We designed this study with the aim of comparing POEM and laparoscopic Heller myotomy+Dor fundoplication (LHD) by matching 2 groups of consecutive patients, treated in 2 high-volume Centers, with the propensity score (PS). Methods Patients undergoing treatment for achalasia from 2014 to 2017 were selected: by applying the PS, 140 patients in both centers were matched. LHD and POEM were performed following established techniques. Patients were followed with clinical, endoscopic and pH-manometry evaluations. Results POEM required a shorter operation time (47 min [35-57]) and postoperative stay (2 days [2-2]) compared to LHD (95 min [85-105] and 3 days [3-3], respectively, p<0.001). No mortality was recorded in either group. Seven complications were recorded in the POEM group (5 mucosal perforations) and 3 in the LHD group (3 mucosal perforations)(p=0.33). At a median follow up of 24 mos. [15-30] for POEM and 31 mos. [15-41] for LHD (p<0.05), the median Eckardt score did not differ: moreover, 99.3% of the POEM patients and 97.7% of the LHD patients showed an Eckardt score ≤ 3 (p <0.12). Four years after the treatment, the probability to be symptom free was > 90% for both groups (98.2% for POEM and 93.9% for LHD, p=0.2, Log-rank test). HR-Manometry showed a similar reduction in the LES pressure and 4sIRP; however, 24-h pH-monitoring showed an abnormal exposure to acid in 38.4% of POEM patients, as compared to 17.1% of LHD patients (p<0.01) and esophagitis was found in 37.4% of the POEM and 15.2% of LHD patients (p<0.05). Finally, the need for PPI therapy was higher in the POEM group (38.8%) compared to the LHD group (15.1%), p<0.001.

scholarly journals Initial outcomes of laparoscopic Heller-Dor myotomy fundoplication for (esophageal) achalasia at Nghe An Friendship General Hospital

2019 ◽  
Vol 9 (4) ◽  
Author(s):  
Van Huong Nguyen ◽  
Keyword(s):  
Weight Loss ◽  
Sample Size ◽  
Heller Myotomy ◽  
Average Length ◽  
Operation Time ◽  
Esophageal Achalasia ◽  
Laparoscopic Heller Myotomy ◽  
Average Weight ◽  
Dor Fundoplication ◽  
Cross Sectional

Abstract Introduction: The aim of this study is to evaluate the outcomes, feasibility and safety of laparoscopic Heller – Dor method in treatment of esophageal achalasia or achalasia . Material and Methods: it’s a descriptive cross-sectional study. The patients diagnosed an achalasia and underwent laparoscopic Heller myotomy and Dor fundoplication from 2014 to July 2019 enrolled. Results: 12 patients diagnosed an achalasia were operated on by laparoscopic Heller myotomy and Dor fundoplication. Age mean 40.8 ± 4.2 (18 -65), male 58.3% and female 41.7%. 83.3% of patients have dysphagia, mean dysphagia time 12.8 ±5.2 (2-60) months, vomiting: 41.7% and weight loss: 100%, average weight loss was 6.7 ± 5.5 (3-15) kg ???.=> does not make sense ! X-ray with contrast of esophageal revealed bird beak sign: 41.7%, sigmoid form 16.7% normal or slight dilation 41.6%. ?? The average operation time was 138.8 ± 9,4 (77-180) mins. The complication occurred during the surgery (bleeding converted to open surgery). No other complications such as perforation occurred during and after the surgery. The average length of postoperative hospital stay was 7.5 ± 0.5 (5-11) days. Quality of life after surgery was very good and good in 83.3% and average 16.7%. Conclusion: Laparoscopic surgery in treatment of achalasia by Heller – Dor technique was safe and effective, with less postoperative pain, fast recovery and short hospital length stays. Almost patients satisfied with the results of this procedure. However, due to the sample size of this study is small so it is necessary to conduct other studies with larger sample size.

scholarly journals Laparoscopic Heller Myotomy and Dor Fundoplication for the Treatment of Esophageal Achalasia After Sleeve Gastrectomy—a Video Vignette

2020 ◽  
Author(s):  
Alberto Aiolfi ◽  
Diego Foschi ◽  
Marco Antonio Zappa ◽  
Alessandra Dell’Era ◽  
Emilia Bareggi ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Heller Myotomy ◽  
Esophageal Achalasia ◽  
Laparoscopic Heller Myotomy ◽  
Gastric Fundus ◽  
Esophageal Wall ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Dor Fundoplication ◽  
Esophageal Motility Disorder

Abstract Purpose Esophageal dysmotility and disorders of the lower esophageal sphincter are well documented in morbidly obese patients. Esophageal achalasia has been reported in up to 1% of obese patients but the development of such esophageal motility disorder after laparoscopic sleeve gastrectomy (LSG) is extremely rare. The purpose of this video was to demonstrate the management of a type II esophageal achalasia diagnosed in a 46-year-old female patient 4-year after LSG. Materials and Methods An intraoperative video has been anonymized and edited to demonstrate the feasibility of laparoscopic Heller myotomy and anterior Dor fundoplication on the mentioned patient. Results The operation started with the section of the perigastric adhesions. Proceeding in a clockwise direction, the esophagogastric junction, the anterior esophageal wall, and the His angle were freed. A residual slightly dilated fundus was found and isolated. After mobilization of the distal esophagus and identification of the anterior vagus nerve, a “hockey stick” myotomy was carried out for 6 cm on the esophagus and for 2 cm on the gastric side. An anterior Dor fundoplication was fashioned using the residual gastric fundus. Conclusion Esophageal achalasia in patients that previously underwent LSG is exceptional but should always be suspected in case of pathognomonic symptoms onset. In tertiary referral centers, laparoscopic Heller myotomy and, if technically feasible, an anterior Dor fundoplication seem safe and effective to relieve gastroesophageal outflow obstruction and prevent gastroesophageal reflux.

scholarly journals Esophageal achalasia detected by vomiting during induction of general anesthesia: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kyoko Abe ◽  
Tetsu Kimura ◽  
Yukitoshi Niiyama
Keyword(s):  
General Anesthesia ◽  
Orthopedic Surgery ◽  
Heller Myotomy ◽  
Esophageal Achalasia ◽  
Anesthesia Induction ◽  
Dor Fundoplication ◽  
Case Presentation ◽  
History Of ◽  
Recovery From Anesthesia ◽  
Risk Of Aspiration

Abstract Background Esophageal achalasia is a rare disease with a high risk of aspiration during anesthesia induction. Here, we describe our experience involving a case of undiagnosed esophageal achalasia with profuse vomiting during anesthesia induction. Case presentation A 58-year-old woman was scheduled for orthopedic surgery under general anesthesia. She vomited a large amount of watery contents during anesthesia induction, and planned surgery was postponed. After recovery from anesthesia, she informed us that she usually had to drink a large amount of water to get food into her stomach and purged watery vomit every night before sleep. However, she attributed it to her constitutional problem, not to a specific disease. She was subsequently diagnosed with esophageal achalasia and underwent Heller myotomy with Dor fundoplication before her re-scheduled orthopedic surgery. Conclusions A detailed history of dysphagia and regurgitation should be taken in preoperative examinations to prevent unexpected aspiration due to undiagnosed achalasia.

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