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16-12-2022 | Gastric Fundoplication | Original Article

Post-Surgical Quality of Life After Laparoscopic Heller Myotomy with Fundoplication for the Treatment of Achalasia

Authors: Alireza Rezapanah, Tooraj Zandbaf, Amin Dalili, Ali Esparham, Soheil Ahmadyar, Saeed Moghaddam Zadeh

Published in: Indian Journal of Surgery | Issue 5/2023

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Abstract 

In this study, we aim to determine the quality of life in patients with achalasia undergoing laparoscopic Heller myotomy with fundoplication after at least 6 months from surgery with Gastroesophageal Reflux Disease Health-Related Quality of Life questionnaire (GERD-HRQL). The study is a cohort study on forty-nine patients who were treated for achalasia between 2014 and 2021. Patients were eligible for the study if they had a minimum of 6-month follow-up after the LHM with fundoplication surgery. All the patients were asked to fill out GERD-HRQL and dysphagia questionnaires. Patients who did not cooperate with the research team were excluded from the study. Forty-six patients were enrolled in this study from 2013 to 2021. The mean ages of patients were 39.76 SD13.69, and 43.5% of them were men. The mean follow-up time for patients was 40.48 SD25.36 months after surgery. The mean GERD-HRQL score and mean dysphagia score were significantly decreased after at least 6 months of surgery (P-value < 0.001 for both). Patients with achalasia undergoing laparoscopic Heller myotomy with fundoplication experience a significant improvement in quality of life with high satisfaction.
Literature
1.
go back to reference Boeckxstaens GE, Zaninotto G, Richter JE (2014) Achalasia. Lancet (London, England) 383(9911):83–93CrossRefPubMed Boeckxstaens GE, Zaninotto G, Richter JE (2014) Achalasia. Lancet (London, England) 383(9911):83–93CrossRefPubMed
2.
go back to reference Pressman A, Behar J (2017) Etiology and pathogenesis of idiopathic achalasia. J Clin Gastroenterol 51(3):195–202CrossRefPubMed Pressman A, Behar J (2017) Etiology and pathogenesis of idiopathic achalasia. J Clin Gastroenterol 51(3):195–202CrossRefPubMed
3.
go back to reference Gockel I, Bohl JR, Doostkam S, Eckardt VF, Junginger T (2006) Spectrum of histopathologic findings in patients with achalasia reflects different etiologies. J Gastroenterol Hepatol 21(4):727–733CrossRefPubMed Gockel I, Bohl JR, Doostkam S, Eckardt VF, Junginger T (2006) Spectrum of histopathologic findings in patients with achalasia reflects different etiologies. J Gastroenterol Hepatol 21(4):727–733CrossRefPubMed
4.
go back to reference Zaninotto G, Bennett C, Boeckxstaens G, Costantini M, Ferguson MK, Pandolfino JE, Patti MG, Ribeiro Jr U, Richter J, Swanstrom L, Tack J (2018) The 2018 ISDE achalasia guidelines. Dis Esophagus 31(9):doy071 Zaninotto G, Bennett C, Boeckxstaens G, Costantini M, Ferguson MK, Pandolfino JE, Patti MG, Ribeiro Jr U, Richter J, Swanstrom L, Tack J (2018) The 2018 ISDE achalasia guidelines. Dis Esophagus 31(9):doy071
5.
go back to reference Samo S, Carlson DA, Gregory DL, Gawel SH, Pandolfino JE, Kahrilas PJ (2017) Incidence and prevalence of achalasia in Central Chicago, 2004–2014, since the widespread use of high-resolution manometry. Clin Gastroenterol Hepatol : Off Clin Pract J Am Gastroenterol Assoc 15(3):366–373CrossRef Samo S, Carlson DA, Gregory DL, Gawel SH, Pandolfino JE, Kahrilas PJ (2017) Incidence and prevalence of achalasia in Central Chicago, 2004–2014, since the widespread use of high-resolution manometry. Clin Gastroenterol Hepatol : Off Clin Pract J Am Gastroenterol Assoc 15(3):366–373CrossRef
6.
go back to reference Enestvedt BK, Williams JL, Sonnenberg A (2011) Epidemiology and practice patterns of achalasia in a large multi-centre database. Aliment Pharmacol Ther 33(11):1209–1214CrossRefPubMed Enestvedt BK, Williams JL, Sonnenberg A (2011) Epidemiology and practice patterns of achalasia in a large multi-centre database. Aliment Pharmacol Ther 33(11):1209–1214CrossRefPubMed
7.
go back to reference Goyal RK, Chaudhury A (2010) Pathogenesis of achalasia: lessons from mutant mice. Gastroenterology 139(4):1086–1090CrossRefPubMed Goyal RK, Chaudhury A (2010) Pathogenesis of achalasia: lessons from mutant mice. Gastroenterology 139(4):1086–1090CrossRefPubMed
8.
go back to reference Stefanidis D, Richardson W, Farrell TM, Kohn GP, Augenstein V, Fanelli RD (2012) SAGES guidelines for the surgical treatment of esophageal achalasia. Surg Endosc 26(2):296–311CrossRefPubMed Stefanidis D, Richardson W, Farrell TM, Kohn GP, Augenstein V, Fanelli RD (2012) SAGES guidelines for the surgical treatment of esophageal achalasia. Surg Endosc 26(2):296–311CrossRefPubMed
9.
go back to reference Yamaguchi D, Tsuruoka N, Sakata Y, Shimoda R, Fujimoto K, Iwakiri R (2015) Safety and efficacy of botulinum toxin injection therapy for esophageal achalasia in Japan. Journal of clinical biochemistry and nutrition 57(3):239–243CrossRefPubMedPubMedCentral Yamaguchi D, Tsuruoka N, Sakata Y, Shimoda R, Fujimoto K, Iwakiri R (2015) Safety and efficacy of botulinum toxin injection therapy for esophageal achalasia in Japan. Journal of clinical biochemistry and nutrition 57(3):239–243CrossRefPubMedPubMedCentral
10.
go back to reference Andreoll NA, Lope LR, Malafai O (2014) Heller’s myotomy: a hundred years of success! Arq Bras Cir Dig 27(1):1–2CrossRefPubMed Andreoll NA, Lope LR, Malafai O (2014) Heller’s myotomy: a hundred years of success! Arq Bras Cir Dig 27(1):1–2CrossRefPubMed
11.
go back to reference Shaligram A, Unnirevi J, Simorov A, Kothari VM, Oleynikov D (2012) How does the robot affect outcomes? A retrospective review of open, laparoscopic, and robotic Heller myotomy for achalasia. Surg Endosc 26(4):1047–1050CrossRefPubMed Shaligram A, Unnirevi J, Simorov A, Kothari VM, Oleynikov D (2012) How does the robot affect outcomes? A retrospective review of open, laparoscopic, and robotic Heller myotomy for achalasia. Surg Endosc 26(4):1047–1050CrossRefPubMed
12.
go back to reference Bhayani NH, Kurian AA, Dunst CM, Sharata AM, Rieder E, Swanstrom LL (2014) A comparative study on comprehensive, objective outcomes of laparoscopic Heller myotomy with per-oral endoscopic myotomy (POEM) for achalasia. Ann Surg 259(6):1098–1103CrossRefPubMed Bhayani NH, Kurian AA, Dunst CM, Sharata AM, Rieder E, Swanstrom LL (2014) A comparative study on comprehensive, objective outcomes of laparoscopic Heller myotomy with per-oral endoscopic myotomy (POEM) for achalasia. Ann Surg 259(6):1098–1103CrossRefPubMed
13.
go back to reference Rebecchi F, Allaix ME, Schlottmann F, Patti MG, Morino M (2018) Laparoscopic Heller myotomy and fundoplication: what is the evidence? Am Surg 84(4):481–488CrossRefPubMed Rebecchi F, Allaix ME, Schlottmann F, Patti MG, Morino M (2018) Laparoscopic Heller myotomy and fundoplication: what is the evidence? Am Surg 84(4):481–488CrossRefPubMed
14.
go back to reference Schneider AM, Louie BE, Warren HF, Farivar AS, Schembre DB, Aye RW (2016) A matched comparison of per oral endoscopic myotomy to laparoscopic Heller myotomy in the treatment of achalasia. J Gastrointest Surg : Off J Soc Surg Aliment Tract 20(11):1789–1796CrossRef Schneider AM, Louie BE, Warren HF, Farivar AS, Schembre DB, Aye RW (2016) A matched comparison of per oral endoscopic myotomy to laparoscopic Heller myotomy in the treatment of achalasia. J Gastrointest Surg : Off J Soc Surg Aliment Tract 20(11):1789–1796CrossRef
15.
go back to reference Stavropoulos SN, Modayil RJ, Friedel D, Savides T (2013) The international per oral endoscopic myotomy survey (IPOEMS): a snapshot of the global POEM experience. Surg Endosc 27(9):3322–3338CrossRefPubMed Stavropoulos SN, Modayil RJ, Friedel D, Savides T (2013) The international per oral endoscopic myotomy survey (IPOEMS): a snapshot of the global POEM experience. Surg Endosc 27(9):3322–3338CrossRefPubMed
17.
go back to reference Werner YB, Hakanson B, Martinek J, Repici A, von Rahden BHA, Bredenoord AJ et al (2019) Endoscopic or surgical myotomy in patients with idiopathic achalasia. N Engl J Med 381(23):2219–2229CrossRefPubMed Werner YB, Hakanson B, Martinek J, Repici A, von Rahden BHA, Bredenoord AJ et al (2019) Endoscopic or surgical myotomy in patients with idiopathic achalasia. N Engl J Med 381(23):2219–2229CrossRefPubMed
18.
go back to reference Teh JL, Tham HY, Soh AY, Chee C, Kim G, Shabbir A, Wong RK, So JB (2022) Gastro-esophageal reflux disease (GERD) after peroral endoscopic myotomy (POEM). Surg Endosc 36(5):3308–3316CrossRefPubMed Teh JL, Tham HY, Soh AY, Chee C, Kim G, Shabbir A, Wong RK, So JB (2022) Gastro-esophageal reflux disease (GERD) after peroral endoscopic myotomy (POEM). Surg Endosc 36(5):3308–3316CrossRefPubMed
19.
go back to reference Schlottmann F, Luckett DJ, Fine J, Shaheen NJ, Patti MG (2018) Laparoscopic Heller myotomy versus peroral endoscopic myotomy (POEM) for achalasia: a systematic review and meta-analysis. Ann Surg 267(3):451–460CrossRefPubMed Schlottmann F, Luckett DJ, Fine J, Shaheen NJ, Patti MG (2018) Laparoscopic Heller myotomy versus peroral endoscopic myotomy (POEM) for achalasia: a systematic review and meta-analysis. Ann Surg 267(3):451–460CrossRefPubMed
20.
go back to reference Kumar A, Raja K, Kumar S, Quasimuddin N, Rizwan A (2020) Quality of life in gastroesophageal reflux disease three months after laparoscopic nissen’s fundoplication. Cureus 12(9):e10674PubMedPubMedCentral Kumar A, Raja K, Kumar S, Quasimuddin N, Rizwan A (2020) Quality of life in gastroesophageal reflux disease three months after laparoscopic nissen’s fundoplication. Cureus 12(9):e10674PubMedPubMedCentral
21.
go back to reference Taft TH, Carlson DA, Triggs J, Craft J, Starkey K, Yadlapati R et al (2018) Evaluating the reliability and construct validity of the Eckardt symptom score as a measure of achalasia severity. Neurogastroenterol Motil : Off J Eur Gastrointest Motil Soc 30(6):e13287CrossRef Taft TH, Carlson DA, Triggs J, Craft J, Starkey K, Yadlapati R et al (2018) Evaluating the reliability and construct validity of the Eckardt symptom score as a measure of achalasia severity. Neurogastroenterol Motil : Off J Eur Gastrointest Motil Soc 30(6):e13287CrossRef
22.
go back to reference Velanovich V (2007) The development of the GERD-HRQL symptom severity instrument. Dis Esophagus : Off J Int Soc Dis Esophagus 20(2):130–134CrossRef Velanovich V (2007) The development of the GERD-HRQL symptom severity instrument. Dis Esophagus : Off J Int Soc Dis Esophagus 20(2):130–134CrossRef
23.
go back to reference Gholoum S, Feldman L, Andrew C, Bergman S, Demyttenaere S, Mayrand S et al (2006) Relationship between subjective and objective outcome measures after Heller myotomy and Dor fundoplication for achalasia. Surg Endosc Other Interv Tech 20(2):214–219CrossRef Gholoum S, Feldman L, Andrew C, Bergman S, Demyttenaere S, Mayrand S et al (2006) Relationship between subjective and objective outcome measures after Heller myotomy and Dor fundoplication for achalasia. Surg Endosc Other Interv Tech 20(2):214–219CrossRef
24.
go back to reference Ali A, Pellegrini CA (2001) Laparoscopic myotomy: technique and efficacy in treating achalasia. Gastrointest Endosc Clin N Am 11(2):347–357CrossRefPubMed Ali A, Pellegrini CA (2001) Laparoscopic myotomy: technique and efficacy in treating achalasia. Gastrointest Endosc Clin N Am 11(2):347–357CrossRefPubMed
26.
go back to reference Richards WO, Torquati A, Holzman MD, Khaitan L, Byrne D, Lutfi R et al (2004) Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: a prospective randomized double-blind clinical trial. Ann Surg 240(3):405CrossRefPubMedPubMedCentral Richards WO, Torquati A, Holzman MD, Khaitan L, Byrne D, Lutfi R et al (2004) Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: a prospective randomized double-blind clinical trial. Ann Surg 240(3):405CrossRefPubMedPubMedCentral
27.
go back to reference Olson MT, Triantafyllou T, Singhal S (2019) A decade of investigation: peroral endoscopic myotomy versus laparoscopic Heller myotomy for achalasia. J Laparoendosc Adv Surg Tech 29(9):1093–1104CrossRef Olson MT, Triantafyllou T, Singhal S (2019) A decade of investigation: peroral endoscopic myotomy versus laparoscopic Heller myotomy for achalasia. J Laparoendosc Adv Surg Tech 29(9):1093–1104CrossRef
28.
go back to reference Asti E, Sironi A, Lovece A, Bonavina G, Fanelli M, Bonitta G et al (2017) Health-related quality of life after laparoscopic Heller myotomy and Dor fundoplication for achalasia. Surgery 161(4):977–983CrossRefPubMed Asti E, Sironi A, Lovece A, Bonavina G, Fanelli M, Bonitta G et al (2017) Health-related quality of life after laparoscopic Heller myotomy and Dor fundoplication for achalasia. Surgery 161(4):977–983CrossRefPubMed
29.
go back to reference Campos GM, Vittinghoff E, Rabl C, Takata M, Gadenstätter M, Lin F et al (2009) Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis. Ann Surg 249(1):45–57CrossRefPubMed Campos GM, Vittinghoff E, Rabl C, Takata M, Gadenstätter M, Lin F et al (2009) Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis. Ann Surg 249(1):45–57CrossRefPubMed
30.
go back to reference Kummerow Broman K, Phillips SE, Faqih A, Kaiser J, Pierce RA, Poulose BK et al (2018) Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: long-term symptomatic follow-up of a prospective randomized controlled trial. Surg Endosc 32(4):1668–1674CrossRefPubMed Kummerow Broman K, Phillips SE, Faqih A, Kaiser J, Pierce RA, Poulose BK et al (2018) Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: long-term symptomatic follow-up of a prospective randomized controlled trial. Surg Endosc 32(4):1668–1674CrossRefPubMed
31.
go back to reference Decker G, Borie F, Bouamrirene D, Veyrac M, Guillon F, Fingerhut A et al (2002) Gastrointestinal quality of life before and after laparoscopic Heller myotomy with partial posterior fundoplication. Ann Surg 236(6):750CrossRefPubMedPubMedCentral Decker G, Borie F, Bouamrirene D, Veyrac M, Guillon F, Fingerhut A et al (2002) Gastrointestinal quality of life before and after laparoscopic Heller myotomy with partial posterior fundoplication. Ann Surg 236(6):750CrossRefPubMedPubMedCentral
Metadata
Title
Post-Surgical Quality of Life After Laparoscopic Heller Myotomy with Fundoplication for the Treatment of Achalasia
Authors
Alireza Rezapanah
Tooraj Zandbaf
Amin Dalili
Ali Esparham
Soheil Ahmadyar
Saeed Moghaddam Zadeh
Publication date
16-12-2022
Publisher
Springer India
Published in
Indian Journal of Surgery / Issue 5/2023
Print ISSN: 0972-2068
Electronic ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-022-03640-9

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