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01-04-2010 | Original Article

Laparoscopic Cardiomyotomy for Achalasia: Clinical Outcomes Beyond 5 Years

Published in: Journal of Gastrointestinal Surgery | Issue 4/2010

Abstract

Background

Laparoscopic cardiomyotomy is the most common surgical procedure for the treatment of achalasia, although few reports describe long-term surgical outcomes.

Methods

The outcomes for 155 patients who underwent a laparoscopic cardiomyotomy with anterior partial fundoplication more than 5 years ago (July 1992 to May 2004) were determined. Patients were followed prospectively at yearly time points using a structured questionnaire which evaluated symptoms of dysphagia, reflux, side-effects, and overall satisfaction with the clinical outcome.

Results

Clinical data were available for 125 patients. Thirteen patients died within 5 years of surgery, four were unable to complete the questionnaire, and one developed esophageal squamous cell carcinoma. Nine patients were lost to follow-up, and three would not answer the questionnaire (92.2% late follow-up). Postoperative dysphagia, odynophagia, chest pain, and heartburn was significantly improved at 1 year, 5 years, and late (5+ years) follow-up, with outcomes stable beyond 12 months. Seventy-seven percent of patients reported a good or excellent result (minimal or no symptoms) at 5 years and 73% at late follow-up. At late follow-up, 90% considered they had made the correct decision to undergo surgery.

Conclusions

At minimum 5 years follow-up, laparoscopic cardiomyotomy for achalasia achieves effective and durable relief of symptoms, and most patients are satisfied with the outcome.

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Title: Laparoscopic Cardiomyotomy for Achalasia: Clinical Outcomes Beyond 5 Years
Publication date: 01-04-2010
Published in: Journal of Gastrointestinal Surgery / Issue 4/2010
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-010-1158-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic Cardiomyotomy for Achalasia: Clinical Outcomes Beyond 5 Years

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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