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Therapeutic Effects of a Laparoscopic Heller Myotomy and Dor Fundoplication on the Chest Pain Associated with Achalasia

Surgery Today volume 36, pages 235–240 (2006)Cite this article

Abstract

Purpose

The therapeutic effects of a laparoscopic Heller myotomy and Dor fundoplication (LHD) on the chest pain associated with achalasia were investigated.

Methods

Sixty-six patients who were diagnosed to have achalasia underwent LHD. The degree of dilatation was assessed based on the maximum horizontal diameter of the esophagus (Grades I–III). The type of dilatation was assessed based on the shape of the distal esophagus, namely, spindle type (Sp), flask type (Fk), and sigmoid type (Sig). The degree of improvement was classified into three grades as follows: A (complete disappearance), B (partial response), and C (unchanged).

Results

Chest pain improved (A or B) in 22 patients (92%). The statistical results revealed that the improvement of postoperative A or B was significantly better in patients with Sp than in those with Fk or Sig (P = 0.0213). In addition, the results revealed that the improvement of postoperative A or B was significantly better in patients with grade I and grade II than in those with grade III (P = 0.004).

Conclusion

LHD is an effective therapeutic technique for the treatment of chest pain associated with achalasia. These results suggest that both the morphological type and esophageal dilatation are useful predictors for the improvement of chest pain after surgical therapy.

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Affiliations

  1. Department of Surgery, Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Nobuo Omura, Hideyuki Kashiwagi, Kazuto Tsuboi, Yoshio Ishibashi, Naruo Kawasaki, Fumiaki Yano, Yutaka Suzuki & Katsuhiko Yanaga

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  1. Nobuo Omura
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  2. Hideyuki Kashiwagi
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  3. Kazuto Tsuboi
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  4. Yoshio Ishibashi
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  5. Naruo Kawasaki
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  6. Fumiaki Yano
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  7. Yutaka Suzuki
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  8. Katsuhiko Yanaga
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Omura, N., Kashiwagi, H., Tsuboi, K. et al. Therapeutic Effects of a Laparoscopic Heller Myotomy and Dor Fundoplication on the Chest Pain Associated with Achalasia. Surg Today 36, 235–240 (2006). https://doi.org/10.1007/s00595-005-3122-4

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  • DOI: https://doi.org/10.1007/s00595-005-3122-4

Key words

  • Achalasia
  • Chest pain
  • Laparoscopic surgery
  • Heller myotomy
  • Dor fundoplication