Limits...
Surgical treatment for achalasia of the esophagus: laparoscopic heller myotomy.

Torres-Villalobos G, Martin-Del-Campo LA - Gastroenterol Res Pract (2013)

Bottom Line: Achalasia is an esophageal motility disorder that leads to dysphagia, chest pain, and weight loss.Its diagnosis is clinically suspected and is confirmed with esophageal manometry.Although pneumatic dilation has a role in the treatment of patients with achalasia, laparoscopic Heller myotomy is considered by many experts as the best treatment modality for most patients with newly diagnosed achalasia.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga No. 15, Colonia Seccion XVI, 14000 Tlalpan, México, DF, Mexico ; Experimental Surgery Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga No. 15, Colonia Seccion XVI, 14000 Tlalpan, México, DF, Mexico.

ABSTRACT
Achalasia is an esophageal motility disorder that leads to dysphagia, chest pain, and weight loss. Its diagnosis is clinically suspected and is confirmed with esophageal manometry. Although pneumatic dilation has a role in the treatment of patients with achalasia, laparoscopic Heller myotomy is considered by many experts as the best treatment modality for most patients with newly diagnosed achalasia. This review will focus on the surgical treatment of achalasia, with special emphasis on laparoscopic Heller myotomy. We will also present a brief discussion of the evaluation of patients with persistent or recurrent symptoms after surgical treatment for achalasia and emerging technologies such as LESS, robot-assisted myotomy, and POEM.

No MeSH data available.


Related in: MedlinePlus

Creation of an anterior partial fundoplication after myotomy.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3852767&req=5

fig3: Creation of an anterior partial fundoplication after myotomy.

Mentions: Therefore, partial fundoplication is the procedure of choice after Heller myotomy (Figure 3). The differences between anterior 180° (Dor) and posterior 270° (Toupet) fundoplication were recently studied in a multicentric, randomized controlled trial that showed no subjective differences in dysphagia or reflux between both groups but did show a higher (not statistically significant) abnormal 24-hour pH-metry (41.7% versus 21%) for the Dor group [16]. Current guidelines state that further high quality is needed in order to find the ideal antireflux procedure after myotomy [6]. We are currently running a prospective, randomized trial comparing Dor versus Toupet fundoplication and evaluating postoperative pH-metry and high-resolution manometry to further solve this question.


Surgical treatment for achalasia of the esophagus: laparoscopic heller myotomy.

Torres-Villalobos G, Martin-Del-Campo LA - Gastroenterol Res Pract (2013)

Creation of an anterior partial fundoplication after myotomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3852767&req=5

fig3: Creation of an anterior partial fundoplication after myotomy.
Mentions: Therefore, partial fundoplication is the procedure of choice after Heller myotomy (Figure 3). The differences between anterior 180° (Dor) and posterior 270° (Toupet) fundoplication were recently studied in a multicentric, randomized controlled trial that showed no subjective differences in dysphagia or reflux between both groups but did show a higher (not statistically significant) abnormal 24-hour pH-metry (41.7% versus 21%) for the Dor group [16]. Current guidelines state that further high quality is needed in order to find the ideal antireflux procedure after myotomy [6]. We are currently running a prospective, randomized trial comparing Dor versus Toupet fundoplication and evaluating postoperative pH-metry and high-resolution manometry to further solve this question.

Bottom Line: Achalasia is an esophageal motility disorder that leads to dysphagia, chest pain, and weight loss.Its diagnosis is clinically suspected and is confirmed with esophageal manometry.Although pneumatic dilation has a role in the treatment of patients with achalasia, laparoscopic Heller myotomy is considered by many experts as the best treatment modality for most patients with newly diagnosed achalasia.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga No. 15, Colonia Seccion XVI, 14000 Tlalpan, México, DF, Mexico ; Experimental Surgery Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga No. 15, Colonia Seccion XVI, 14000 Tlalpan, México, DF, Mexico.

ABSTRACT
Achalasia is an esophageal motility disorder that leads to dysphagia, chest pain, and weight loss. Its diagnosis is clinically suspected and is confirmed with esophageal manometry. Although pneumatic dilation has a role in the treatment of patients with achalasia, laparoscopic Heller myotomy is considered by many experts as the best treatment modality for most patients with newly diagnosed achalasia. This review will focus on the surgical treatment of achalasia, with special emphasis on laparoscopic Heller myotomy. We will also present a brief discussion of the evaluation of patients with persistent or recurrent symptoms after surgical treatment for achalasia and emerging technologies such as LESS, robot-assisted myotomy, and POEM.

No MeSH data available.


Related in: MedlinePlus