title: Preoperative dilatation does not affect the surgical outcome of laparoscopic Heller myotomy and Dor fundoplication for esophageal achalasia.
abstract: BACKGROUND
  Laparoscopic Heller myotomy and Dor fundoplication are now widely performed for achalasia. In patients who have had dilatation in the past, inflammation between the esophageal mucosal and muscular layers may make it difficult to perform myotomy.
  
  
  OBJECTIVE
  We investigated the effects of preoperative dilatation on the surgical outcomes.
  
  
  METHODS
  : One hundred and twelve patients were divided into 2 groups: 37 patients with a past history of preoperative dilatation and 75 patients who had no history of preoperative dilatation. The operating time, intraoperative blood loss, days required to resume postoperative oral intake, postoperative hospital stay, improvement in dysphagia, and incidence of postoperative esophagitis were compared.
  
  
  RESULTS
  The operating time, intraoperative blood loss, postoperative hospital stay, and improvement of dysphagia were no significant differences between these groups. Furthermore, there were no significant differences in the incidence of postoperative esophagitis.
  
  
  CONCLUSIONS
  The therapeutic outcome of laparoscopic Heller myotomy and Dor fundoplication is not affected by preoperative pneumatic dilatation.
authors.affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan. kazuto@jikei.ac.jp
authors.forename: Kazuto
authors.initials: K
authors.lastname: Tsuboi
authors.forename: Nobuo
authors.initials: N
authors.lastname: Omura
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Yano
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kashiwagi
authors.forename: Naruo
authors.initials: N
authors.lastname: Kawasaki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D002648:Child; D004931:Esophageal Achalasia / Q000601:surgery*; D016629:Esophagectomy / Q000295:instrumentation / Q000379:methods*; D004942:Esophagitis, Peptic / Q000601:surgery; D005260:Female; D018662:Fundoplication / Q000379:methods*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult