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Laparoscopic Heller-Dor operation for patients with achalasia

Background Laparoscopic Heller cardiomyotomy and Dor fundoplication is the surgical procedure of choice for esophageal achalasia. The aim of this study was to investigate the clinical outcome of laparoscopic Heller-Dor procedure in our initial series of 25 patients with achalasia. Methods Between Oc... Full description

Journal Title: Chinese medical journal 2006, Vol.119 (6), p.443-447
Main Author: Wang, Qiu-sheng
Other Authors: Liu, Long , Dong, Lei , Shen, Zhan-long , Zhou, Dong-hai , Hu, Chun-xiang
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: China
ID: ISSN: 0366-6999
Link: https://www.ncbi.nlm.nih.gov/pubmed/16584640
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recordid: cdi_proquest_miscellaneous_67827308
title: Laparoscopic Heller-Dor operation for patients with achalasia
format: Article
creator:
  • Wang, Qiu-sheng
  • Liu, Long
  • Dong, Lei
  • Shen, Zhan-long
  • Zhou, Dong-hai
  • Hu, Chun-xiang
subjects:
  • Adult
  • Aged
  • Digestive System Surgical Procedures - methods
  • Esophageal Achalasia - surgery
  • Esophagus - surgery
  • Female
  • Follow-Up Studies
  • Fundoplication - methods
  • Humans
  • Laparoscopy - methods
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures - methods
  • 弛缓不能
  • 检查方法
  • 腹腔镜
  • 食管疾病
ispartof: Chinese medical journal, 2006, Vol.119 (6), p.443-447
description: Background Laparoscopic Heller cardiomyotomy and Dor fundoplication is the surgical procedure of choice for esophageal achalasia. The aim of this study was to investigate the clinical outcome of laparoscopic Heller-Dor procedure in our initial series of 25 patients with achalasia. Methods Between October 2003 and January 2006, a total of 25 patients with achalasia underwent laparoscopic Heller-Dor operation. Among them, 9 were male and 16 were female with an average age of (41.5 ± 5.1) years (21- 66). All the patients received upper gastrointestinal series (barium swallow), esophagogastroscopy, esophageal manometry to exclude esophageal carcinoma and to confirm the diagnosis, and 21 patients also had 24-hour ambulatory pH studies. All the patients were operated by laparoscopic modified Heller's myotomy with Dor fundoplication. In addition, 2 of them had combined laparoscopic cholecystectomy ± excision of hepatic hemangioma and laparoscopic cholecystectomy, respectively. Results The average operating time was (110.6± 12.9) minutes (range, 60-180), operative blood loss averaged (18.6±7.1) ml (5-50), the median time to oral feeding was (1.6±0.4) days (1-4) and the median hospital stay was (12.6± 1.2) days (10-20). There was no conversion to open surgery. Intraoperative mucosal perforation was encountered in six patients and was repaired in all of them by laparoscopic suture. All the patients had an uneventful recovery without postoperative complication. After a median follow-up of (10.6 ± 7.2) months (1 -27), 24 patients were asymptomatic and 1 had mild postoperative dysphagia. Conclusions Laparoscopic Heller-Dor operation had the advantages of reduced compromise of the cardiopulmonary function, with less disruption of the supporting structures (phrenoesophageal membrane) of the antireflux mechanism, requiting simpler general anesthesia and providing excellent exposure permitting an easy fundoplication, less pain and reduced morbidity, shorter hospitalization and faster convalescence.
language: eng
source:
identifier: ISSN: 0366-6999
fulltext: no_fulltext
issn:
  • 0366-6999
  • 2542-5641
url: Link


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titleLaparoscopic Heller-Dor operation for patients with achalasia
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descriptionBackground Laparoscopic Heller cardiomyotomy and Dor fundoplication is the surgical procedure of choice for esophageal achalasia. The aim of this study was to investigate the clinical outcome of laparoscopic Heller-Dor procedure in our initial series of 25 patients with achalasia. Methods Between October 2003 and January 2006, a total of 25 patients with achalasia underwent laparoscopic Heller-Dor operation. Among them, 9 were male and 16 were female with an average age of (41.5 ± 5.1) years (21- 66). All the patients received upper gastrointestinal series (barium swallow), esophagogastroscopy, esophageal manometry to exclude esophageal carcinoma and to confirm the diagnosis, and 21 patients also had 24-hour ambulatory pH studies. All the patients were operated by laparoscopic modified Heller's myotomy with Dor fundoplication. In addition, 2 of them had combined laparoscopic cholecystectomy ± excision of hepatic hemangioma and laparoscopic cholecystectomy, respectively. Results The average operating time was (110.6± 12.9) minutes (range, 60-180), operative blood loss averaged (18.6±7.1) ml (5-50), the median time to oral feeding was (1.6±0.4) days (1-4) and the median hospital stay was (12.6± 1.2) days (10-20). There was no conversion to open surgery. Intraoperative mucosal perforation was encountered in six patients and was repaired in all of them by laparoscopic suture. All the patients had an uneventful recovery without postoperative complication. After a median follow-up of (10.6 ± 7.2) months (1 -27), 24 patients were asymptomatic and 1 had mild postoperative dysphagia. Conclusions Laparoscopic Heller-Dor operation had the advantages of reduced compromise of the cardiopulmonary function, with less disruption of the supporting structures (phrenoesophageal membrane) of the antireflux mechanism, requiting simpler general anesthesia and providing excellent exposure permitting an easy fundoplication, less pain and reduced morbidity, shorter hospitalization and faster convalescence.
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subjectAdult ; Aged ; Digestive System Surgical Procedures - methods ; Esophageal Achalasia - surgery ; Esophagus - surgery ; Female ; Follow-Up Studies ; Fundoplication - methods ; Humans ; Laparoscopy - methods ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures - methods ; 弛缓不能 ; 检查方法 ; 腹腔镜 ; 食管疾病
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descriptionBackground Laparoscopic Heller cardiomyotomy and Dor fundoplication is the surgical procedure of choice for esophageal achalasia. The aim of this study was to investigate the clinical outcome of laparoscopic Heller-Dor procedure in our initial series of 25 patients with achalasia. Methods Between October 2003 and January 2006, a total of 25 patients with achalasia underwent laparoscopic Heller-Dor operation. Among them, 9 were male and 16 were female with an average age of (41.5 ± 5.1) years (21- 66). All the patients received upper gastrointestinal series (barium swallow), esophagogastroscopy, esophageal manometry to exclude esophageal carcinoma and to confirm the diagnosis, and 21 patients also had 24-hour ambulatory pH studies. All the patients were operated by laparoscopic modified Heller's myotomy with Dor fundoplication. In addition, 2 of them had combined laparoscopic cholecystectomy ± excision of hepatic hemangioma and laparoscopic cholecystectomy, respectively. Results The average operating time was (110.6± 12.9) minutes (range, 60-180), operative blood loss averaged (18.6±7.1) ml (5-50), the median time to oral feeding was (1.6±0.4) days (1-4) and the median hospital stay was (12.6± 1.2) days (10-20). There was no conversion to open surgery. Intraoperative mucosal perforation was encountered in six patients and was repaired in all of them by laparoscopic suture. All the patients had an uneventful recovery without postoperative complication. After a median follow-up of (10.6 ± 7.2) months (1 -27), 24 patients were asymptomatic and 1 had mild postoperative dysphagia. Conclusions Laparoscopic Heller-Dor operation had the advantages of reduced compromise of the cardiopulmonary function, with less disruption of the supporting structures (phrenoesophageal membrane) of the antireflux mechanism, requiting simpler general anesthesia and providing excellent exposure permitting an easy fundoplication, less pain and reduced morbidity, shorter hospitalization and faster convalescence.
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abstractBackground Laparoscopic Heller cardiomyotomy and Dor fundoplication is the surgical procedure of choice for esophageal achalasia. The aim of this study was to investigate the clinical outcome of laparoscopic Heller-Dor procedure in our initial series of 25 patients with achalasia. Methods Between October 2003 and January 2006, a total of 25 patients with achalasia underwent laparoscopic Heller-Dor operation. Among them, 9 were male and 16 were female with an average age of (41.5 ± 5.1) years (21- 66). All the patients received upper gastrointestinal series (barium swallow), esophagogastroscopy, esophageal manometry to exclude esophageal carcinoma and to confirm the diagnosis, and 21 patients also had 24-hour ambulatory pH studies. All the patients were operated by laparoscopic modified Heller's myotomy with Dor fundoplication. In addition, 2 of them had combined laparoscopic cholecystectomy ± excision of hepatic hemangioma and laparoscopic cholecystectomy, respectively. Results The average operating time was (110.6± 12.9) minutes (range, 60-180), operative blood loss averaged (18.6±7.1) ml (5-50), the median time to oral feeding was (1.6±0.4) days (1-4) and the median hospital stay was (12.6± 1.2) days (10-20). There was no conversion to open surgery. Intraoperative mucosal perforation was encountered in six patients and was repaired in all of them by laparoscopic suture. All the patients had an uneventful recovery without postoperative complication. After a median follow-up of (10.6 ± 7.2) months (1 -27), 24 patients were asymptomatic and 1 had mild postoperative dysphagia. Conclusions Laparoscopic Heller-Dor operation had the advantages of reduced compromise of the cardiopulmonary function, with less disruption of the supporting structures (phrenoesophageal membrane) of the antireflux mechanism, requiting simpler general anesthesia and providing excellent exposure permitting an easy fundoplication, less pain and reduced morbidity, shorter hospitalization and faster convalescence.
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