The influence of operation technique on long-term results of achalasia treatment
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. This was a retrospective study, where 46 achalasia...
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| Veröffentlicht in: | Medicina (Kaunas, Lithuania) Lithuania), 2013-01, Vol.49 (2), p.56-60 |
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| container_title | Medicina (Kaunas, Lithuania) |
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| creator | Kiudelis, Mindaugas Mechonosina, Kristina Mickevičius, Antanas Maleckas, Almantas Endzinas, Žilvinas |
| description | 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.
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.
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 (P0.05). Clinically significant heartburn was documented in 39% of patients in the group 1 and only in 13% of patients in the group 2 (P |
| doi_str_mv | 10.3390/medicina49020010 |
| format | Article |
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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.
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).
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.</description><identifier>ISSN: 1648-9144</identifier><identifier>EISSN: 1648-9144</identifier><identifier>DOI: 10.3390/medicina49020010</identifier><identifier>PMID: 23888339</identifier><language>eng</language><publisher>Switzerland</publisher><subject>Adult ; Aged ; Cardia - surgery ; Deglutition Disorders - etiology ; Deglutition Disorders - surgery ; Esophageal Achalasia - complications ; Esophageal Achalasia - surgery ; Fundoplication - methods ; Heartburn - etiology ; Heartburn - surgery ; Humans ; Laparoscopy - methods ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult</subject><ispartof>Medicina (Kaunas, Lithuania), 2013-01, Vol.49 (2), p.56-60</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c341t-55cefadf66b5197cd38d00d897b891daceaba4e1fbfddc71ab63cc8a6de46ae3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,864,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23888339$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kiudelis, Mindaugas</creatorcontrib><creatorcontrib>Mechonosina, Kristina</creatorcontrib><creatorcontrib>Mickevičius, Antanas</creatorcontrib><creatorcontrib>Maleckas, Almantas</creatorcontrib><creatorcontrib>Endzinas, Žilvinas</creatorcontrib><title>The influence of operation technique on long-term results of achalasia treatment</title><title>Medicina (Kaunas, Lithuania)</title><addtitle>Medicina (Kaunas)</addtitle><description>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.
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.
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).
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.</description><subject>Adult</subject><subject>Aged</subject><subject>Cardia - surgery</subject><subject>Deglutition Disorders - etiology</subject><subject>Deglutition Disorders - surgery</subject><subject>Esophageal Achalasia - complications</subject><subject>Esophageal Achalasia - surgery</subject><subject>Fundoplication - methods</subject><subject>Heartburn - etiology</subject><subject>Heartburn - surgery</subject><subject>Humans</subject><subject>Laparoscopy - methods</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>1648-9144</issn><issn>1648-9144</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkDFPwzAQhS0EoqWwM6GMLAE7dhxnRBUFpEowdI8u9pkaJU6xnYF_T6oWhJjudPfe09NHyDWjd5zX9L5H47TzIGpaUMroCZkzKVReMyFO_-wzchHjB6W8KKvinMwKrpSaEubkbbPFzHnbjeg1ZoPNhh0GSG7wWUK99e5znM4-6wb_nicMfRYwjl2Key3oLXQQHWQpIKQefbokZxa6iFfHuSCb1eNm-ZyvX59elg_rXHPBUl6WGi0YK2VbsrrShitDqVF11aqaGdAILQhktrXG6IpBK7nWCqRBIQH5gtweYndhmBrG1PQuauw68DiMsWGCcSY5pdUkpQepDkOMAW2zC66H8NUw2uwxNv8xTpabY_rYTs9fww83_g3103JI</recordid><startdate>20130101</startdate><enddate>20130101</enddate><creator>Kiudelis, Mindaugas</creator><creator>Mechonosina, Kristina</creator><creator>Mickevičius, Antanas</creator><creator>Maleckas, Almantas</creator><creator>Endzinas, Žilvinas</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130101</creationdate><title>The influence of operation technique on long-term results of achalasia treatment</title><author>Kiudelis, Mindaugas ; Mechonosina, Kristina ; Mickevičius, Antanas ; Maleckas, Almantas ; Endzinas, Žilvinas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c341t-55cefadf66b5197cd38d00d897b891daceaba4e1fbfddc71ab63cc8a6de46ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Cardia - surgery</topic><topic>Deglutition Disorders - etiology</topic><topic>Deglutition Disorders - surgery</topic><topic>Esophageal Achalasia - complications</topic><topic>Esophageal Achalasia - surgery</topic><topic>Fundoplication - methods</topic><topic>Heartburn - etiology</topic><topic>Heartburn - surgery</topic><topic>Humans</topic><topic>Laparoscopy - methods</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kiudelis, Mindaugas</creatorcontrib><creatorcontrib>Mechonosina, Kristina</creatorcontrib><creatorcontrib>Mickevičius, Antanas</creatorcontrib><creatorcontrib>Maleckas, Almantas</creatorcontrib><creatorcontrib>Endzinas, Žilvinas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Medicina (Kaunas, Lithuania)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kiudelis, Mindaugas</au><au>Mechonosina, Kristina</au><au>Mickevičius, Antanas</au><au>Maleckas, Almantas</au><au>Endzinas, Žilvinas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The influence of operation technique on long-term results of achalasia treatment</atitle><jtitle>Medicina (Kaunas, Lithuania)</jtitle><addtitle>Medicina (Kaunas)</addtitle><date>2013-01-01</date><risdate>2013</risdate><volume>49</volume><issue>2</issue><spage>56</spage><epage>60</epage><pages>56-60</pages><issn>1648-9144</issn><eissn>1648-9144</eissn><abstract>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.
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.
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).
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.</abstract><cop>Switzerland</cop><pmid>23888339</pmid><doi>10.3390/medicina49020010</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Aged Cardia - surgery Deglutition Disorders - etiology Deglutition Disorders - surgery Esophageal Achalasia - complications Esophageal Achalasia - surgery Fundoplication - methods Heartburn - etiology Heartburn - surgery Humans Laparoscopy - methods Middle Aged Retrospective Studies Treatment Outcome Young Adult |
| title | The influence of operation technique on long-term results of achalasia treatment |
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