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Effect of preoperative balloon dilation on treatment outcomes of laparoscopic Heller–Dor surgery for achalasia: a propensity score matched study

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Abstract

Purpose

There is some debate about whether preoperative balloon dilation influences the outcomes of laparoscopic Heller–Dor surgery (LHD), with no consensus opinion as yet. Thus, we investigated if preoperative dilation influences the treatment outcomes of LHD for achalasia.

Methods

The subjects of this study were 526 patients with achalasia who underwent LHD as an initial treatment between August 1994 and February 2017. The patients were roughly classified by the status of preoperative balloon dilation and matched with propensity scores for age, sex, BMI, morphologic type, and maximum esophageal transverse diameter. Consequently, 94 subjects each were assigned to the balloon dilation (BD) group and to the non-balloon dilation (non-BD) group. We evaluated patient backgrounds, surgical outcomes, and incidence of postoperative reflux esophagitis.

Results

No differences were found in surgical time, intraoperative blood loss, incidence of intraoperative mucosal injury, or postoperative hospital stay between the BD and non-BD groups. The mean patient satisfaction was significantly higher in the non-BD group (4.9) than in the BD group (4.7) and the incidence of postoperative esophagitis was significantly lower in the non-BD group (1.1%) than in the BD group (7.4%).

Conclusions

Preoperative balloon dilation had no effect on intraoperative complications but did increase the incidence of postoperative reflux esophagitis in patients undergoing LHD for achalasia.

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Authors and Affiliations

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

    Kazuto Tsuboi, Nobuo Omura, Fumiaki Yano, Masato Hoshino, Se-Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi & Katsuhiko Yanaga

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  1. Kazuto Tsuboi
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  2. Nobuo Omura
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  3. Fumiaki Yano
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  4. Masato Hoshino
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  5. Se-Ryung Yamamoto
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  6. Shunsuke Akimoto
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  7. Takahiro Masuda
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  8. Hideyuki Kashiwagi
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  9. Katsuhiko Yanaga
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Correspondence to Kazuto Tsuboi.

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Tsuboi, K., Omura, N., Yano, F. et al. Effect of preoperative balloon dilation on treatment outcomes of laparoscopic Heller–Dor surgery for achalasia: a propensity score matched study. Surg Today 48, 1068–1075 (2018). https://doi.org/10.1007/s00595-018-1695-y

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  • DOI: https://doi.org/10.1007/s00595-018-1695-y

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