title: Post-Surgical Quality of Life, Psychological State and what Patients Think about the Effectiveness of Heller Myotomy in the Treatment of Achalasia.
abstract: BACKGROUND
  The disruption of esophageal motility that characterizes achalasia typically provokes dysphagia, pain, loss of weight and malnutrition. Therefore, patients frequently report a reduction in quality of life and negative emotional states. Laparoscopic Heller myotomy proved to be an effective therapy, enabling the resumption of good quality of life.
  
  
  METHODS
  The authors studied 45 patients previously submitted to laparoscopic Heller myotomy. Postoperative evaluation was performed using a customized version of the achalasia disease-specific quality of life questionnaire. Quality of life and the presence of depressive and anxiety symptoms were assessed using the Portuguese versions of the Medical Outcomes Study SF-36 and the Hospital Anxiety and Depression Scale.
  
  
  RESULTS
  Thirty-one patients responded to the survey. Dysphagia was the main clinical symptom before surgery. A clear improvement in dysphagia, regurgitation, pain and weight loss was found after surgery (p < 0.001). The Mental Health domain of SF-36 presented a Pearson correlation coefficient of -0.689 with HADS-D and of -0.557 with HADS-A (p < 0.001 and p = 0.002, respectively).
  
  
  CONCLUSIONS
  This study demonstrates that the Heller myotomy is associated with a good quality of life in patients with achalasia and strengthens the evidence that this is a safe and reliable procedure.
authors.affiliation: Faculty of Medicine. University of Porto. Department of General Surgery. Hospital of São João. Porto.
authors.forename: Telma
authors.initials: T
authors.lastname: Vale-Fonseca
authors.affiliation: Department of Orthopedic Surgery. Centro Hospitalar Tondela-Viseu. Viseu. Center for Health Technology and Services Research ' CINTESIS. Porto. Department of Health and Decision Sciences ' CIDES. Faculty of Medicine. University of Porto. Porto.
authors.forename: Luis
authors.initials: L
authors.lastname: Ferreira-Pinto
authors.affiliation: Department of Clinical Neurosciences and Mental Health. Faculty of Medicine. University of Porto. Porto.
authors.forename: Margarida
authors.initials: M
authors.lastname: Figueiredo-Braga
authors.affiliation: Faculty of Medicine. University of Porto. Porto. Department of General Surgery. Hospital of São João. Porto.
authors.forename: Silvestre
authors.initials: S
authors.lastname: Carneiro
mesh_terms: D001007:Anxiety / Q000209:etiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D059026:Diagnostic Self Evaluation; D013505:Digestive System Surgical Procedures / Q000379:methods; D004931:Esophageal Achalasia / Q000150:complications / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D016896:Treatment Outcome