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European Surgery
Published in: European Surgery 5/2018

01-10-2018 | case report

Laparoscopic Heller myotomy and Dor fundoplication after failed POEM: case report and literature review

Authors: Simone Zanghì, Francesco Toti, Alberto Aiolfi, Prof. Luigi Bonavina

Published in: European Surgery | Issue 5/2018

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Summary

Background

Persistent achalasia-related symptoms after POEM(Per-Oral Endoscopic Myotomy) pose a therapeutic challenge.

Methods

We reviewed the hospital charts of a patient presenting with persistent dysphagia, chest pain, and regurgitation after POEM. A review of the pertinent literature was also performed.

Results

A 49-year-old man with a history of dysphagia for the previous 5 years was referred to our center after failure of POEM. He was diagnosed with type II achalasia and underwent POEM 2 months later in another hospital. Dysphagia, chest pain, and regurgitation persisted. The patient underwent four sessions of achalasia balloon dilatation without symptom resolution. Laparoscopic Heller myotomy and Dor fundoplication was successfully performed. At the 6‑month follow-up, the patient is symptom free.

Conclusions

Incomplete distal myotomy or scarring may account for persistent symptoms after POEM. Laparoscopic Heller myotomy and Dor fundoplication is a safe and effective approach.
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Metadata
Title
Laparoscopic Heller myotomy and Dor fundoplication after failed POEM: case report and literature review
Authors
Simone Zanghì
Francesco Toti
Alberto Aiolfi
Prof. Luigi Bonavina
Publication date
01-10-2018
Publisher
Springer Vienna
Published in
European Surgery / Issue 5/2018
Print ISSN: 1682-8631
Electronic ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-018-0554-9

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