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


Background/Aims: Currently, forceful endoscopic pneumatic balloon dilatation (PBD), laparoscopic Heller myotomy (LHM) with or without

an anti-reflux procedure, and peroral endoscopic myotomy are the preferred treatment options for achalasia. The aim of the present

study was to retrospectively compare postoperative outcomes after LHM plus Dor fundoplication (DF) between patients who underwent

prior endoscopic balloon dilatation and 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 had a history of endoscopic PBD. Pre- and postoperative achalasia symptoms, including weight loss, dysphagia,

heartburn, and regurgitation, were evaluated using the Eckardt score.


Results: Fifty (76.9%) patients underwent laparoscopic surgery and 15 (23.1%) underwent open surgery. When patients were compared

according to the presence of preoperative endoscopic PBD, no significant difference were observed in terms of age, sex, preoperative

lower esophageal sphincter 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). In contrast,

no significant difference was found between patients with and without previous PBD on the pre- and postoperative Eckardt scores



Conclusion: HM+DF is an effective procedure in relieving achalasia symptoms as a first-line therapy as well as 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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AVES | Copyright © 2019 Turkish Society of Gastroenterology | Latest Update: 09.05.2019