Laparoscopic Heller Myotomy for Achalasia Cardianitial Experience in a Teaching Institute

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• 作者：Lileswar Kaman (1)
  Javid Iqbal (1)
  Rakesh Kochhar (2)
  Saroj Sinha (2)
  
• 关键词：Achalasia cardia ; Laparoscopy Hellers myotomy ; Dor fundoplications
• 刊名：Indian Journal of Surgery
• 出版年：2013
• 出版时间：October 2013
• 年：2013
• 卷：75
• 期：5
• 页码：391-394
• 全文大小：
• 作者单位：Lileswar Kaman (1)
  Javid Iqbal (1)
  Rakesh Kochhar (2)
  Saroj Sinha (2)
  
  1. Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  2. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  
• ISSN：0973-9793

文摘

Laparoscopic Heller cardiomyotomy and Dor fundoplication is the surgical procedure of choice for esophageal achalasia. The aim of our study was to investigate the clinical outcome and safety of laparoscopic Helleror procedure performed by using Hook electrocautery and as a teaching module for advanced laparoscopic surgery. Between January 2005 and December 2010, 25 consecutive patients with achalasia underwent laparoscopic Helleror operation by a single surgeon. All the patients received upper gastrointestinal series (barium swallow), esophagogastroscopy, and esophageal manometry to exclude esophageal carcinoma and to confirm the diagnosis. All the patients were operated by laparoscopic modified Heller myotomy with Dor fundoplication by using hook electrocautery. Among 25 operated patients, 14 were male and 11 were female with a median age of 43years (range 182years). The mean operative time was 93.3min (range 500min), the mean operative blood loss was 90ml (range 4000ml), the median time to oral feeding was 2days (2days), and the median hospital stay was 4days (4days). There was no conversion to open surgery. Intraoperative mucosal perforation was encountered in three patients and was repaired in all of them by laparoscopic suture. All the patients had an uneventful recovery without postoperative complication and had excellent clinical response (96%) during follow-up. Laparoscopic Helleror operation using hook electrocautery is safe, inexpensive, and effective treatment for achalasia which is useful for teaching and training surgical residents in advanced laparoscopic surgery.