Laparoscopic Heller myotomy with Dor fundoplication for achalasia. Result of 17 years experience

Abstract

Objective: To expose the experience in the management of achalasia at General Surgery Service of Centro Médico “Dr. Rafael Guerra Méndez”. Valencia, Venezuela. Patients and method: This is a retrospective, descriptive and analytical study based on the review of laparoscopic surgical records previously designed, of patients admitted between 1992 and 2009 with diagnosis of achalasia. We evaluated
gender, age, symptoms and its evolution, surgical time and complications. The results are presented as absolute and relative frequency measurements. Results: There were performed 27 procedures predominantely on male patients ( 55,56 %). The age group more frequent
affected was between 3rd and 4th decade (more than 70 %). In most cases, symptomatology was dysphagia, regurgitation and thoracic pain, presented in 70 % of patients, from 3 up to 9 years with this clinic. Average surgical time was 158 minutes +/- 32,35. There were 2 intraoperative complications (7,4 %), and minor postoperative complications. There was not mortality. Three patients (11,11 %) need postoperative dilatations for  dysphagia. Conclusion: Laparoscopic approach is a safe and reliable method in the treatment of achalasia. A longer follow-up is needed to evaluate this technique.