Preoperative dilatation does not affect the surgical outcome of laparoscopic Heller myotomy and Dor fundoplication for esophageal achalasia.
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.
Tsuboi
Kazuto
K
Department of Surgery, Jikei University School of Medicine, Tokyo, Japan. kazuto@jikei.ac.jp
Omura
Nobuo
N
Yano
Fumiaki
F
Kashiwagi
Hideyuki
H
Kawasaki
Naruo
N
Suzuki
Yutaka
Y
Yanaga
Katsuhiko
K
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