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Conference Paper: Minimally invasive surgery for achalasia

TitleMinimally invasive surgery for achalasia
Authors
KeywordsMedical sciences
Otorhinolaryngology
Issue Date2012
PublisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/DES
Citation
The 13th World Congress of the International Society for Diseases of the Esophagus, Venice, Italy, 15-17 October 2012. In Diseases of the Esophagus, 2012, v. 25 suppl. S1, p. 123A, abstract no. P06.08 How to Cite?
AbstractBACKGROUND: There are various surgical treatment approaches for achalasia. The outcome of achalasia patients treated with surgery is evaluated. METHODS: From 1994 to 2011, 63 with achalasia were treated by myotomy with or without anti-reflux procedure. The demographics and peri-operative outcomes were analyzed. RESULTS: The median age of the studied population was 37 years (range: 13–67) and 29 (46%) were men. The median duration of symptoms prior to presentation was 18 months (range: 1–36). Prior to surgery, 12 (19%) patients had had non-operative intervention; one patient (1.6%) had botulinum toxin injection and 11 (17.5%) had balloon dilatation. The median number of dilatations was 1 (range: 1–5). Surgical procedures evolved over time; which included thoracoscopic myotomy (n = 9, 14.3%), laparoscopic myotomy (n = 13, 20.6%), laparoscopic myotomy plus Dor hemifundoplication (n = 27, 42.9%), and robotic-assisted laparoscopic myotomy plus Dor hemifundoplication (n = 14, 22.2%). There was no conversion to open surgery. Four patients (6.3%) had esophageal mucosal perforations, all were repaired with no postoperative leak. Pulmonary complication was higher using the thoracoscopic compared to laparoscopic approach, at 33.3% vs. 1.9% (p < 0.01). The duration of follow-up was 25 months (range: 1–150). The mean dysphagia score improved from 3.08 to 1.22 postoperatively. Reflux esophagitis was documented in 9 (40.9%) and 1 (2.4%) patients without and with anti-reflux procedure respectively (p < 0.01). Two patients required balloon dilatation related to persistent dysphagia. DISCUSSION: Minimally invasive surgery for achalasia provides durable and excellent symptoms relief. Anti-reflux procedure significantly reduces postoperative acid reflux.
DescriptionPoster Session P06 - Motility Disorders: no. P06.08
This journal suppl. is the Special Issue: abstracts presented at the 13th World Congress of the International Society for Diseases of the Esophagus 2012
Persistent Identifierhttp://hdl.handle.net/10722/177490
ISSN
2015 Impact Factor: 2.146
2015 SCImago Journal Rankings: 0.760

 

DC FieldValueLanguage
dc.contributor.authorTong, Den_US
dc.contributor.authorLaw, Sen_US
dc.contributor.authorChan, Fen_US
dc.date.accessioned2012-12-18T05:13:35Z-
dc.date.available2012-12-18T05:13:35Z-
dc.date.issued2012en_US
dc.identifier.citationThe 13th World Congress of the International Society for Diseases of the Esophagus, Venice, Italy, 15-17 October 2012. In Diseases of the Esophagus, 2012, v. 25 suppl. S1, p. 123A, abstract no. P06.08en_US
dc.identifier.issn1120-8694-
dc.identifier.urihttp://hdl.handle.net/10722/177490-
dc.descriptionPoster Session P06 - Motility Disorders: no. P06.08-
dc.descriptionThis journal suppl. is the Special Issue: abstracts presented at the 13th World Congress of the International Society for Diseases of the Esophagus 2012-
dc.description.abstractBACKGROUND: There are various surgical treatment approaches for achalasia. The outcome of achalasia patients treated with surgery is evaluated. METHODS: From 1994 to 2011, 63 with achalasia were treated by myotomy with or without anti-reflux procedure. The demographics and peri-operative outcomes were analyzed. RESULTS: The median age of the studied population was 37 years (range: 13–67) and 29 (46%) were men. The median duration of symptoms prior to presentation was 18 months (range: 1–36). Prior to surgery, 12 (19%) patients had had non-operative intervention; one patient (1.6%) had botulinum toxin injection and 11 (17.5%) had balloon dilatation. The median number of dilatations was 1 (range: 1–5). Surgical procedures evolved over time; which included thoracoscopic myotomy (n = 9, 14.3%), laparoscopic myotomy (n = 13, 20.6%), laparoscopic myotomy plus Dor hemifundoplication (n = 27, 42.9%), and robotic-assisted laparoscopic myotomy plus Dor hemifundoplication (n = 14, 22.2%). There was no conversion to open surgery. Four patients (6.3%) had esophageal mucosal perforations, all were repaired with no postoperative leak. Pulmonary complication was higher using the thoracoscopic compared to laparoscopic approach, at 33.3% vs. 1.9% (p < 0.01). The duration of follow-up was 25 months (range: 1–150). The mean dysphagia score improved from 3.08 to 1.22 postoperatively. Reflux esophagitis was documented in 9 (40.9%) and 1 (2.4%) patients without and with anti-reflux procedure respectively (p < 0.01). Two patients required balloon dilatation related to persistent dysphagia. DISCUSSION: Minimally invasive surgery for achalasia provides durable and excellent symptoms relief. Anti-reflux procedure significantly reduces postoperative acid reflux.-
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/DES-
dc.relation.ispartofDiseases of the Esophagusen_US
dc.rightsThe definitive version is available at www3.interscience.wiley.com-
dc.subjectMedical sciences-
dc.subjectOtorhinolaryngology-
dc.titleMinimally invasive surgery for achalasiaen_US
dc.typeConference_Paperen_US
dc.identifier.emailTong, D: esodtong@hku.hken_US
dc.identifier.emailLaw, S: slaw@hku.hken_US
dc.identifier.emailChan, F: fsychan@hku.hken_US
dc.identifier.authorityLaw, S=rp00437en_US
dc.identifier.doi10.1111/j.1442-2050.2012.01405.x-
dc.identifier.hkuros212751en_US
dc.identifier.hkuros212754-
dc.identifier.volume25-
dc.identifier.issuesuppl. S1-
dc.identifier.spage123A-
dc.identifier.epage123A-
dc.publisher.placeAustralia-

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