PS01.028: REOPERATIONS AFTER FAILED HELLER´S MYOTOMY FOR ESOPHAGEAL ACHALASIA
2018; Oxford University Press; Volume: 31; Issue: Supplement_1 Linguagem: Inglês
10.1093/dote/doy089.ps01.028
ISSN1442-2050
AutoresRosalba Roque González, Miguel Ángel Martínez, Jorge Gerardo Pereira, Raul Jiménez, Vivianne Anido, Felipe Neri Pinol,
Tópico(s)Esophageal and GI Pathology
ResumoAbstract Background Heller's cardiomyotomy associated with the anti-reflux procedure described by Dor is the treatment of choice in patients with esophageal achalasia. However, the causes of treatment failure are still controversial. The primary aim of this study is to describe the causes of failure of Heller's myotomy in patients operated on due to esophageal achalasia and the clinical progress of patients who required another surgery. Methods A descriptive, retrospective and longitudinal study of a series of patients who required another surgery due to failure of Heller's myotomy from January 2010 to December 2016. Results Heller's myotomy was performed in 253 patients diagnosed with esophageal achalasia. Of these patients, 7 (2.7%) required another surgery due to recurrence of symptoms, 4 (1.5%) were initially operated on at the institution and the rest were referred from other institutions in the country. Laparoscopic approach was utilized in 5 patients and 2 were treated thoracoscopically. The mean age was 41 ± 15 years (range 20–59). The most frequent symptoms were postoperative dysphagia and weight loss (100%). The time of recurrence of symptoms after the first operation was 6–12 months in 4 patients (57%), 12 to 18 months in 1 (16%) and 18 to 24 in 2 (33%) patients. Conclusion Incomplete myotomy was the main cause of reoperation, with laparoscopic re-myotomy with or without fundoplication being the surgical technique of choice for these patients, who had an excellent or good postoperative clinical progress. Disclosure All authors have declared no conflicts of interest.
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