Laparoscopic cardiomyotomy with a Dor patch for achalasia

P. C. Mitchell, D. I. Watson, P. G. Devitt, R. Britten-Jones, S. MacDonald, J. C. Myers, G. G. Jamieson

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30 Citations (Scopus)

Abstract

Objective: To evaluate early experience with laparoscopic Heller's cardiomyotomy with placement of a Dor patch for achalasia. Design: A prospective case series. Settings: A university teaching hospital. Patients: Fourteen patients (5 men, 9 women, median age 47 years) with esophageal achalasia, treated between July 1992 and July 1994. Interventions: Laparoscopic Heller's cardiomyotomy with a Dor patch. Main outcome measures: Clinical relief of symptoms, confirmed by esophageal manometry, 24-hour ambulatory pH monitoring and barium-contrast radiography. Results: Three of the 14 patients required conversion to an open procedure, and 1 underwent early laparotomy for postoperative bleeding. The median operating time was 120 minutes (range from 75 to 210 minutes), and the median duration of hospitalization was 4 days (range from 3 to 18 days). Normal physical activity was resumed after a menian of 2 weeks (range from 0.5 to 6 weeks). Symptomatic dysphagia was completely relieved in 12 patients and improved in 2. Only one patient experienced symptoms of reflux postoperatively. Postoperative esophageal manometry (seven patients), 24-hour pH monitoring (five patients) and barium-meal radiography (seven patients) confirmed the clinical results. Conclusion: Laparoscopic Heller's cardiomyotomy with a Dor patch provides a viable alternative to open cardiomyotomy and forceful endoscopic dilatation.

Original languageEnglish
Pages (from-to)445-448
Number of pages4
JournalCANADIAN JOURNAL OF SURGERY
Volume38
Issue number5
Publication statusPublished - Oct 1995
Externally publishedYes

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    Mitchell, P. C., Watson, D. I., Devitt, P. G., Britten-Jones, R., MacDonald, S., Myers, J. C., & Jamieson, G. G. (1995). Laparoscopic cardiomyotomy with a Dor patch for achalasia. CANADIAN JOURNAL OF SURGERY, 38(5), 445-448.