Results of laparoscopic Heller myotomy and Dor fundoplication in treatment of achalasia

Abstract

Abstract Introduction: Achalasia is a primary esophageal motor disorder, which is relatively rare. Patients usually start silently and detect late for months to years. Therefore, laparoscopic Heller myotomy is now considered the surgical procedure of choice for treating achalasia. Anti-reflux procedure usually performed by surgeons is a Dor procedure because of its many advantages, and it is easy to perform in laparoscopic surgery. Purpose: The objectives of this study is to determine the incidence and complications of laparoscopic Heller myotomy and Dor fundoplication and determine percentage improvement dysphagia after surgery. Material and Methods: Patients diagnosed achalasia and underwent laparoscopic Heller myotomy and Dor fundoplication at the Digestive Surgery Department of Cho Ray hospital from January 2011 to May 2017. Results: 23 patients with achalasia were operated on for laparoscopic Heller myotomy and Dor fundoplication. 95.7% of patient have dysphagia, regurgitation: 39.1%, and weight loss: 46%. The grade of patients with the highest diameter of the esophagus: 13.04% degree I, 52.18% degree II, 13.04% degree III, 21.74% degree IV. Average surgery time was 150.22 ± 35.63 minutes. Complication in surgery: esophageal perforation occurred in about 13.04% cases, there was 4.35% of bleeding reported. Quality of life after surgery was good and very good at 91.3%. Conclusion: The results of laparoscopic Heller myotomy and Dor fundoplication were effective, most patients satisfied the results of surgery. However, the size of this study is limited so it is necessary to follow up with other studies with larger sample size.