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The laparoscopic Heller-Dor operation remains an effective treatment for esophageal achalasia at a minimum 6-year follow-up

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Abstract

Background

The aim of this study was to investigate the long-term clinical outcome of the laparoscopic Heller Dor procedure for esophageal achalasia.

Methods

A total of 71 consecutive patients with a minimum 6 year follow-up were evaluated. These patients were seen at 1 and 6 months after the operation (at which time barium swallow, endoscopy, manometry, and pH monitoring were performed), and annually thereafter. A dedicated symptom score, that combined severity and frequency of symptoms was used.

Results

The median symptom score decreased from 22 (range, 9-29) preoperatively to 4 (range, 0-16) at last follow-up, (p < 0.01). During the follow-up period, 13 patients suffered symptom recurrence; seven of them (54%) had already been diagnosed at the 1-year follow-up. All of these patients were treated with complementary pneumatic dilations. Overall, at a minimum of 6- years after the operation, 81.7% of the patients were satisfied with the treatment and were able to eat normally.

Conclusions

The long-term outcome of laparoscopic surgical treatment of esophageal achalasia is only slightly affected by the length of the follow-up and most of the symptomatic failures occur in the early period after the operation.

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Acknowledgments

This work was supported in part by grant no. 9906198133 from the Italian Ministry for Research and the University of Padua

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences (Clinical Chirurgica III), School of Medicine, University of Padua, via Giustiniani, 35128, Padua, Italy

    M. Costantini, G. Zaninotto, E. Guirroli, C. Rizzetto, G. Portale, A. Ruol, L. Nicoletti & E. Ancona

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  1. M. Costantini
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  2. G. Zaninotto
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  3. E. Guirroli
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  4. C. Rizzetto
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  5. G. Portale
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  6. A. Ruol
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  7. L. Nicoletti
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  8. E. Ancona
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Correspondence to M. Costantini.

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Costantini, M., Zaninotto, G., Guirroli, E. et al. The laparoscopic Heller-Dor operation remains an effective treatment for esophageal achalasia at a minimum 6-year follow-up. Surg Endosc 19, 345–351 (2005). https://doi.org/10.1007/s00464-004-8941-7

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  • DOI: https://doi.org/10.1007/s00464-004-8941-7

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