Laparoscopic Heller myotomy for achalasia

Results after 10 years

Sarah M. Cowgill, Desiree Villadolid, Robert Boyle, Sam Al-Saadi, Sharona Ross, Alexander S. Rosemurgy

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background: Laparoscopic Heller myotomy was first undertaken in the early 1990s, and appreciable numbers of patients with 10-year follow-up periods are now available. This study was undertaken to determine long-term outcomes after laparoscopic Heller myotomy used to treat achalasia. Methods: Of 337 patients who have undergone laparoscopic Heller myotomy since 1992, 47 who underwent myotomy more than 10 years ago have been followed through a prospectively maintained registry. Among many symptoms, patients scored dysphagia, chest pain, vomiting, regurgitation, choking, and heartburn before and after myotomy using a Likert scale with choices ranging from 0 (never/not bothersome) to 10 (always/very bothersome). Symptom scores before and after myotomy were compared using a Wilcoxon matched-pairs test. Data are reported as median (mean ± standard deviation). Results: The median length of the hospital stay was 2 days (mean, 3 ± 8.6 days; range, 1-60 days). Notable complications were infrequent after myotomy. There were no perioperative deaths. One patient required a redo myotomy after 5 years due to recurrence of symptoms. At this writing, 33 patients (70%) are still alive. The causes of death after discharge were unrelated to myotomy. The frequency and severity scores for dysphagia, chest pain, vomiting, regurgitation, choking, and heartburn all decreased significantly after laparoscopic Heller myotomy (p < 0.0001 for all). Conclusions: Laparoscopic Heller myotomy can be undertaken with few complications. This procedure significantly decreases the frequency and severity of achalasia symptoms without promoting heartburn. The symptoms of achalasia are durably ameliorated by laparoscopic Heller myotomy during long-term follow-up evaluation, thereby promoting application of this procedure.

Original languageEnglish (US)
Pages (from-to)2644-2649
Number of pages6
JournalSurgical Endoscopy
Volume23
Issue number12
DOIs
StatePublished - Jan 1 2009

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Esophageal Achalasia
Heartburn
Airway Obstruction
Deglutition Disorders
Chest Pain
Vomiting
Length of Stay
Registries
Cause of Death
Recurrence

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Cowgill, S. M., Villadolid, D., Boyle, R., Al-Saadi, S., Ross, S., & Rosemurgy, A. S. (2009). Laparoscopic Heller myotomy for achalasia: Results after 10 years. Surgical Endoscopy, 23(12), 2644-2649. https://doi.org/10.1007/s00464-009-0508-1
Cowgill, Sarah M. ; Villadolid, Desiree ; Boyle, Robert ; Al-Saadi, Sam ; Ross, Sharona ; Rosemurgy, Alexander S. / Laparoscopic Heller myotomy for achalasia : Results after 10 years. In: Surgical Endoscopy. 2009 ; Vol. 23, No. 12. pp. 2644-2649.
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Cowgill, SM, Villadolid, D, Boyle, R, Al-Saadi, S, Ross, S & Rosemurgy, AS 2009, 'Laparoscopic Heller myotomy for achalasia: Results after 10 years', Surgical Endoscopy, vol. 23, no. 12, pp. 2644-2649. https://doi.org/10.1007/s00464-009-0508-1

Laparoscopic Heller myotomy for achalasia : Results after 10 years. / Cowgill, Sarah M.; Villadolid, Desiree; Boyle, Robert; Al-Saadi, Sam; Ross, Sharona; Rosemurgy, Alexander S.

In: Surgical Endoscopy, Vol. 23, No. 12, 01.01.2009, p. 2644-2649.

Research output: Contribution to journalArticle

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T1 - Laparoscopic Heller myotomy for achalasia

T2 - Results after 10 years

AU - Cowgill, Sarah M.

AU - Villadolid, Desiree

AU - Boyle, Robert

AU - Al-Saadi, Sam

AU - Ross, Sharona

AU - Rosemurgy, Alexander S.

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