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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

The Influence of Operation Technique on Long-Term Results of Achalasia Treatment

Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Lithuania
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Medicina 2013, 49(2), 10; https://doi.org/10.3390/medicina49020010
Received: 12 January 2013 / Accepted: 28 February 2013 / Published: 5 March 2013
Currently, the most effective therapy for achalasia is laparoscopic Heller myotomy with partial fundoplication. The aim of this study was to compare the long-term results between 2 different laparoscopic operation techniques in achalasia treatment.
Material and Methods.
This was a retrospective study, where 46 achalasia patients were examined: 23 patients underwent laparoscopic Heller myotomy followed by the full gastric fundus mobilization, total hiatal dissection, and posterior Toupet (270°) fundoplication (group 1); other 23 patients underwent laparoscopic Heller myotomy with limited surgical cardia region dissection, not dividing the short gastric vessels and performing anterior partial Dor fundoplication (group 2). Long-term findings included the evaluation of postoperative dysphagia according Vantrappen and Hellemans and intensity of heartburn according the standard grading system.
Results
. The patients in these 2 groups were similar in terms of age, weight, height, and postoperative hospital stay. The median follow-up was 66 months in the group 1 and 39 months in the group 2 (P<0.05). Laparoscopic operation was effective in 82.6% of patients (excellent and good results) in the group 1; treatment was effective in 78.3% of patients in the group 2 (P>0.05). Clinically significant heartburn was documented in 39% of patients in the group 1 and only in 13% of patients in the group 2 (P<0.05).
Conclusions
. According our study results, both laparoscopic techniques were similarly effective (82.6% vs. 78.3%) in achalasia treatment. Postoperative heartburn was significantly more common (39% vs. 13%) after laparoscopic myotomy, followed by the full gastric fundus mobilization, total hiatal dissection, and posterior Toupet (270°) fundoplication.
Keywords: achalasia; dysphagia; laparoscopic Heller myotomy; Toupet fundoplication; Dor fundoplication achalasia; dysphagia; laparoscopic Heller myotomy; Toupet fundoplication; Dor fundoplication
MDPI and ACS Style

Kiudelis, M.; Mechonosina, K.; Mickevičius, A.; Maleckas, A.; Endzinas, Ž. The Influence of Operation Technique on Long-Term Results of Achalasia Treatment. Medicina 2013, 49, 10.

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