Abstract
Background: The 1outcomes of a laparoscopic esophagomyotomy with posterior partial fundoplication were compared between groups of patients with primary motility disorders.
Methods: In this study, 47 patients (26 women and 21 men, ages 24 to 77 years; mean, 47 years) with significant dysphagia or chest pain who failed conservative treatment underwent a laparoscopic esophagomyotomy and posterior partial fundoplication. Preoperative evaluation revealed four groups of primary motility disorders: achalasia (n=12), nutcracker esophagus (n=12), hypertensive lower esophageal sphincter (LES) (n=16), and diffuse esophageal spasm (n=7). Statistical analysis was performed by Cramer’s V test.
Results: Average follow-up period was 30.3 months. There was no mortality or early morbidity. Late morbidity included dysphagia or chest pain over 6 weeks in 10 patients (21%), recurrent gastroesophageal reflux disease (GERD) in 3 patients (6%), and recurrent motility disorder in 2 patients (4%). Overall, 94% of the patients ultimately had complete resolution of dysphagia or chest pain. There was no significant difference in outcomes between groups.
Conclusion: Early results suggest that laparoscopic esophagomyotomy with posterior partial fundoplication provides safe and effective relief from dysphagia and chest pain in patients with each of the primary motility disorders.
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Online publication: 13 June 2000
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Champion, J.K., Delisle, N. & Hunt, T. Laparoscopic esophagomyotomy with posterior partial fundoplication for primary esophageal motility disorders. Surg Endosc 14, 746–749 (2000). https://doi.org/10.1007/s004640000147
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DOI: https://doi.org/10.1007/s004640000147