Laparoscopic cardiomyotomy is an effective treatment for achalasia. Intraoperative leak tests are carried out to exclude mucosal perforations, additionally some surgeon perform postoperative contrast swallows. The aim of the study was to identify whether postoperative contrast swallows were necessary in all patients who undergo laparoscopic cardiomyotomy. All patients who underwent a laparoscopic cardiomyotomy at a single center between 2004 and 2011 were identified. Median age was 55 (18 to 79), median body mass index 26 (17 to 37), and median length of stay was 1 day (1 to 4). A total of 54% of patients had previous pneumatic dilatations. One intraoperative mucosal perforation was identified and repaired. No leaks were seen on the postoperative swallow; however, 1 patient was readmitted with a contained leak, 8 days after surgery. Postoperative contrast swallow did not have any clinical impact. We suggest that they are only indicated if there is a clinical concern and that laparoscopic cardiomyotomy can be safely carried out as a day case procedure.
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http://dx.doi.org/10.1097/SLE.0b013e3182901660 | DOI Listing |
Med J Armed Forces India
December 2024
Consultant (Med & Gastroenterology), Command Hospital (Eastern Command), Kolkata, India.
Background: Achalasia is characterized by failure of relaxation of the lower oesophageal sphincter (LOS) and abnormal peristalsis during swallowing. The study aimed to observe the effects of intervention in three sub-types of achalasia and compare the intervention outcomes among the three sub-types.
Methods: Forty-one patients underwent Eckardt scoring for severity of achalasia, followed by high-resolution manometry (HRM).
Heliyon
September 2024
Department of General Surgery, Habib Thameur Hospital, Tunis, Tunisia.
The standard of care for achalasia is laparoscopic Heller's cardiomyotomy. This procedure achieves satisfactory and long-standing results in over 85 % of patients. However, disease progression occurs in some patients leading to end-stage achalasia, occasionally requiring oesophagectomy.
View Article and Find Full Text PDFCureus
August 2024
General Surgery, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, Mumbai, IND.
A 45-year-old man who presented with progressive dysphagia of five months duration was diagnosed as a case of oesophageal epiphrenic diverticulum after endoscopic and imaging investigations. He underwent laparoscopic cardiomyotomy with Dor's fundoplication. Myotomy was done from the base of the diverticulum up to 2 cm distal to the gastroesophageal junction.
View Article and Find Full Text PDFArq Bras Cir Dig
July 2024
Pontifícia Universidade Católica de Campinas, Postgraduate Program of Health Sciences, Campinas (SP), Brazil.
Background: Advanced megaesophagus predisposes to risks of malnutrition infections and cancer, in addition to having a significant impact on quality of life. There is currently no consensus in the literature regarding the best surgical option for advanced megaesophagus, although there is a predilection for esophagectomy, despite this surgery being associated with significant morbidity and mortality. Other surgical procedures, such as esophageal mucosectomy and Heller cardiomyotomy, have been proposed with good results.
View Article and Find Full Text PDFBMC Gastroenterol
March 2024
Department of Surgery, University Hospital Center, Yaoundé, Cameroon.
Introduction: Achalasia is a rare esophageal disease with potentially lethal complications. Knowledge of the outcomes of the different surgical treatment modalities for achalasia by Heller's cardiomyotomy (HCM) helps to choose the safest and most effective option. However, data on the management of achalsia using a Heller myotomy is limited in Africa.
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