Long-term Symptom Control After Laparoscopic Heller Myotomy and Dor Fundoplication for Achalasia

BackgroundAchalasia is a primary esophageal motility disorder in which there incomplete relaxation of the lower sphincter and absence peristalsis two thirds esophagus. A favored treatment laparoscopic modified Heller myotomy with Dor fundoplication (LHMDor) more than 90% immediate beneficial effect. The short-term outcomes LHMDor are well documented, but stability durability postoperative symptom control over time less understood.MethodsBetween 2004 2016, 54 patients achalasia underwent (single center). Using validated questionnaires, rated their symptoms five domains: pain, gastroesophageal reflux disease (GERD), dysphagia, regurgitation, quality life. Symptom ratings were done preoperatively, 4 weeks postoperatively, 6 months yearly after operation.ResultsAs expected, reported marked improvement odynophagia, GERD, life operation (P < .001). From then on, remained durable respect to odynophagia; however, we observed recurrence GERD beginning 3 5 years postoperatively = .001 P .04, respectively), associated increased antireflux medication use. After initial LHMDor, required endoscopic dilatation an average 1.5 no patient reoperation. Patients preserved improved 11 .001).ConclusionsThese results demonstrate definitive management achalasia, offering consistent symptomatic relief significant decade surgery, despite some increase Achalasia understood. Between operation. As These