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Results of the surgical treatment of non-advanced megaesophagus using Heller-Pinotti's surgery: Laparotomy vs. Laparoscopy.

Lopes LR, Braga Nda S, Oliveira GC, Coelho Neto Jde S, Camargo MA, Andreollo NA - Clinics (Sao Paulo) (2011)

Bottom Line: The Heller-Pinotti technique is the method preferred by Brazilian surgeons.Mean duration of follow-up was 8 years.There was no difference between the two groups with respect to relief from dysphagia, thereby confirming the safety and effectiveness of the Heller-Pinotti technique, which can be performed by laparotomy or laparoscopy, depending on the surgeon's experience.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of Campinas, Campinas, São Paulo, Brazil. lopeslr@fcm.unicamp.br

ABSTRACT

Introduction: Dysphagia is the important symptom in achalasia, and surgery is the most common treatment. The Heller-Pinotti technique is the method preferred by Brazilian surgeons. For many years, this technique was performed by laparotomy, and now the laparoscopic method has been introduced. The objective was to evaluate the immediate and long-term results of patients submitted to surgery by either laparotomy or laparoscopy.

Materials and methods: A total of 67 patients submitted to surgery between 1994 and 2001 with at least 5 years of follow-up were evaluated retrospectively and divided into two groups: laparotomy (41 patients) and laparoscopy (26 patients). Chagas was the etiology in 76.12% of cases. Dysphagia was evaluated according to the classification defined by Saeed et al.

Results: There were no cases of conversion to open surgery. The mean duration of hospitalization was 3.32 days for laparotomy and 2.54 days for laparoscopy (p < 0.05). An improvement in dysphagia occurred with both groups reporting good or excellent results (laparotomy: 73.17% and laparoscopy: 73.08%). Mean duration of follow-up was 8 years.

Conclusions: There was no difference between the two groups with respect to relief from dysphagia, thereby confirming the safety and effectiveness of the Heller-Pinotti technique, which can be performed by laparotomy or laparoscopy, depending on the surgeon's experience.

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Making the forefront of fundoplication after approaching the stomach to the esophagus.
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f2-cln_66p41: Making the forefront of fundoplication after approaching the stomach to the esophagus.

Mentions: The surgical technique used was Heller myotomy to an extent of around 9 cm, approximately 6 cm of the esophagus and 3 cm of the stomach, after which a valve was fashioned in three posterior–anterior layers as described by Pinotti et al.,11 wrapping the exposed area of submucosa along its entire length. This procedure was performed using either median xifoumbilical laparotomy or videolaparoscopy (Figures 1–4).


Results of the surgical treatment of non-advanced megaesophagus using Heller-Pinotti's surgery: Laparotomy vs. Laparoscopy.

Lopes LR, Braga Nda S, Oliveira GC, Coelho Neto Jde S, Camargo MA, Andreollo NA - Clinics (Sao Paulo) (2011)

Making the forefront of fundoplication after approaching the stomach to the esophagus.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3044574&req=5

f2-cln_66p41: Making the forefront of fundoplication after approaching the stomach to the esophagus.
Mentions: The surgical technique used was Heller myotomy to an extent of around 9 cm, approximately 6 cm of the esophagus and 3 cm of the stomach, after which a valve was fashioned in three posterior–anterior layers as described by Pinotti et al.,11 wrapping the exposed area of submucosa along its entire length. This procedure was performed using either median xifoumbilical laparotomy or videolaparoscopy (Figures 1–4).

Bottom Line: The Heller-Pinotti technique is the method preferred by Brazilian surgeons.Mean duration of follow-up was 8 years.There was no difference between the two groups with respect to relief from dysphagia, thereby confirming the safety and effectiveness of the Heller-Pinotti technique, which can be performed by laparotomy or laparoscopy, depending on the surgeon's experience.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of Campinas, Campinas, São Paulo, Brazil. lopeslr@fcm.unicamp.br

ABSTRACT

Introduction: Dysphagia is the important symptom in achalasia, and surgery is the most common treatment. The Heller-Pinotti technique is the method preferred by Brazilian surgeons. For many years, this technique was performed by laparotomy, and now the laparoscopic method has been introduced. The objective was to evaluate the immediate and long-term results of patients submitted to surgery by either laparotomy or laparoscopy.

Materials and methods: A total of 67 patients submitted to surgery between 1994 and 2001 with at least 5 years of follow-up were evaluated retrospectively and divided into two groups: laparotomy (41 patients) and laparoscopy (26 patients). Chagas was the etiology in 76.12% of cases. Dysphagia was evaluated according to the classification defined by Saeed et al.

Results: There were no cases of conversion to open surgery. The mean duration of hospitalization was 3.32 days for laparotomy and 2.54 days for laparoscopy (p < 0.05). An improvement in dysphagia occurred with both groups reporting good or excellent results (laparotomy: 73.17% and laparoscopy: 73.08%). Mean duration of follow-up was 8 years.

Conclusions: There was no difference between the two groups with respect to relief from dysphagia, thereby confirming the safety and effectiveness of the Heller-Pinotti technique, which can be performed by laparotomy or laparoscopy, depending on the surgeon's experience.

Show MeSH
Related in: MedlinePlus