Laparoscopic cardiomyotomy for achalasia: A single unit study.
OBJECTIVE
Achalasia is a rare incurable neuromuscular disorder of the oesophagus. A number of treatment options are available. We reviewed our results of laparoscopic cardiomyotomy over a 30 month period.


METHODS
18 patients with manometric features of achalasia underwent surgery between 2004 and 2006. Pre and postoperative weight and dysphagia scores were recorded (maximum score 45=normal, 0=complete dysphagia). Change in the Body Mass Index (BMI) was measured. Other symptoms (heartburn, epigastric pain, regurgitation, odynophagia and sleep disturbance) were scored on a 0-4 scale of increasing severity.


RESULTS
At mean follow up of 16.2 months the mean dysphagia score was significantly improved from 7.5 to 33.9 (p<0.005). BMI was significantly increased from 22.3 to 25.8 kg/m(2) (p<0.05). Scores for heartburn, epigastric pain, regurgitation, odynophagia and sleep disturbance were also significantly improved. The average inpatient stay was 3.1 days and average operating time 111 minutes. One mucosal perforation occurred which was repaired intraoperatively. No patients required secondary operative intervention.


CONCLUSIONS
Laparoscopic cardiomyotomy is a safe, highly effective, minimally invasive treatment for achalasia.
Kennedy
R
R
Department of Upper Gastrointestinal Surgery, Royal Victoria Hospital Grosvenor Road, Belfast BT12 6BA. rpg.kennedy@btinternet.com
Menezes
C
C
Ahmad
J
J
Kennedy
J A
JA
D000328:Adult; D015992:Body Mass Index; D002299:Cardia / Q000601:surgery*; D003680:Deglutition Disorders; D004931:Esophageal Achalasia / Q000601:surgery*; D049630:Esophageal Sphincter, Lower / Q000601:surgery; D004945:Esophagoscopy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D018662:Fundoplication / Q000379:methods; D006305:Health Status Indicators; D006801:Humans; D007297:Inpatients; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult