Laparoscopic cardiomyotomy for achalasia: Clinical outcomes beyond 5 years.

Zhen Chen, Justin Bessell, Andrew Chew, David Watson

    Research output: Contribution to journalArticlepeer-review

    49 Citations (Scopus)

    Abstract

    Background: Laparoscopic cardiomyotomy is the most common surgical procedure for the treatment of achalasia, although few reports describe long-term surgical outcomes. Methods: The outcomes for 155 patients who underwent a laparoscopic cardiomyotomy with anterior partial fundoplication more than 5 years ago (July 1992 to May 2004) were determined. Patients were followed prospectively at yearly time points using a structured questionnaire which evaluated symptoms of dysphagia, reflux, side-effects, and overall satisfaction with the clinical outcome. Results: Clinical data were available for 125 patients. Thirteen patients died within 5 years of surgery, four were unable to complete the questionnaire, and one developed esophageal squamous cell carcinoma. Nine patients were lost to follow-up, and three would not answer the questionnaire (92. 2% late follow-up). Postoperative dysphagia, odynophagia, chest pain, and heartburn was significantly improved at 1 year, 5 years, and late (5+ years) follow-up, with outcomes stable beyond 12 months. Seventy-seven percent of patients reported a good or excellent result (minimal or no symptoms) at 5 years and 73% at late follow-up. At late follow-up, 90% considered they had made the correct decision to undergo surgery. Conclusions: At minimum 5 years follow-up, laparoscopic cardiomyotomy for achalasia achieves effective and durable relief of symptoms, and most patients are satisfied with the outcome.

    Original languageEnglish
    Pages (from-to)594-600
    Number of pages7
    JournalJournal of Gastrointestinal Surgery
    Volume14
    Issue number4
    DOIs
    Publication statusPublished - Apr 2010

    Keywords

    • Achalasia
    • Cardiomyotomy
    • Dysphagia
    • Esophagus
    • Laparoscopy
    • Long-term follow-up

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