The laparoscopic Heller-Dor operation remains an effective treatment for esophageal achalasia at a minimum 6-year follow-up.
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 of 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.
Costantini
M
M
Department of Medical and Surgical Sciences, Clinical Chirurgica III, School of Medicine, University of Padua, via Giustiniani, 35128, Padua, Italy. m.costantini@unipd.it
Zaninotto
G
G
Guirroli
E
E
Rizzetto
C
C
Portale
G
G
Ruol
A
A
Nicoletti
L
L
Ancona
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods; D004931:Esophageal Achalasia / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000601:surgery*; D013997:Time Factors