E-ISSN 2148-5607
1 Department of Gastroenterological Surgery, Türkiye High Training and Research Hospital, Ankara, Turkey  
Turk J Gastroenterol ; : -

Abstract

 

Background/Aims: Currently, forceful endoscopic pneumatic balloon dilatation (PBD), laparoscopic Heller’s myotomy (LHM) with or without an anti-reflux procedure and peroral endoscopic myotomy (POEM) are the preferred treatment options for achalasia. The aim of the present study is to retrospectively compare the postoperative outcomes after LHM plus Dor fundoplication (DF) between patients who underwent prior endoscopic balloon dilatation with those who did not.

 

Materials and Methods: Sixty-five patients who underwent HM + DF between January 2008 and December 2016 were retrospectively analyzed. Of these, 45 patients had a history of endoscopic PBD. Pre- and postoperative achalasia symptoms were evaluated by using Eckardt Score including weight loss, dysphagia, heartburn and regurgitation.

 

Results: Fifty patients (76.9%) underwent laparoscopic surgery whereas 15 patients (23.1%) open surgery. When patients were compared according to the presence of preoperative endoscopic PBD; there was no significant difference in terms of age, gender, preoperative LES pressure, operation time, hospitalization period and follow up period, (P>0.05). The mean Eckardt Score at the first postoperative year was significantly lower than the preoperative Eckardt Score (4.51±1.8 vs 0.52±0.7, (P<0.001)). On the other hand, no significant difference was found between patients with and without previous PBD regarding preoperative and postoperative Eckardt Scores (p= 0.43).

 

Conclusion: HM + DF is an effective procedure in relieving symptoms of achalasia not only as a first line therapy but also in individuals unresponsive to repeated endoscopic PBDs.

 

 

Cite this article as: Öter V, Bostancı EB, Karaman K, Sümer F, Özer İ. The effects of preoperative endoscopic pneumatic balloon dilatation on postoperative achalasia symptoms after Heller’s esophageal myotomy plus Dor fundoplication. Turk J Gastroenterol 2018; 29: DOI: 10.5152/tjg.2018.17822

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