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Surgical Endoscopy

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01-10-2007

Outcomes promote reoperative Heller myotomy for symptoms of achalasia

Authors: S. Rakita, D. Villadolid, C. Kalipersad, D. Thometz, A. Rosemurgy

Published in: Surgical Endoscopy | Issue 10/2007

Abstract

Background

Heller myotomy is accepted as first-line therapy for achalasia, yet for a small number of patients, symptoms persist or recur after myotomy. This study was undertaken to report our results with reoperative laparoscopic Heller myotomy for recurrent symptoms of achalasia.

Methods

We have undertaken laparoscopic Heller myotomy in 275 patients and reoperative myotomy in 12 patients for recurrent dysphagia, of which three had their initial myotomy undertaken by us. For each, studies prior to reoperative Heller myotomy documented a nonrelaxing lower esophageal sphincter without stricture. Patients scored symptoms before and after reoperative myotomy.

Results

Before reoperative myotomy, 75% underwent dilation and 42% underwent Botox injection. Ten of twelve reoperative myotomies were undertaken and completed laparoscopically. Median follow-up is 24.1 months (29.0 months + 25.89). Symptom frequency and severity scores improved significantly after reoperative myotomy. Frequency of vomiting and frequency and severity of heartburn were improved after reoperative myotomy, but not to a significant extent. However, they were not particularly notable prior to surgery, compared to obstructive symptoms, such as dysphagia. Excellent or good outcomes were reported in 73%, and notably, 91% stated that they would have the operation again after having been through the process firsthand and knowing their outcomes.

Conclusion

Patient outcomes promote the application of reoperative Heller myotomy for recurrent or persistent symptoms of achalasia following Heller myotomy.

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Title: Outcomes promote reoperative Heller myotomy for symptoms of achalasia
Authors: S. Rakita
D. Villadolid
C. Kalipersad
D. Thometz
A. Rosemurgy
Publication date: 01-10-2007
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 10/2007
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-007-9226-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Outcomes promote reoperative Heller myotomy for symptoms of achalasia

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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