Τίτλος:
Long-term outcome of myotomy and fundoplication based on intraoperative real-time high-resolution manometry in achalasia patients
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background Current treatment options for achalasia of the esophagus predominantly consist of endoscopic myotomy or laparoscopic myotomy combined with a partial fundoplication. The intraoperative use of conventional manometry has previously been proposed with various results. The aim of the present study was to introduce the use of high-resolution manometry (HRM) during surgical treatment for achalasia and to assess the long-term outcome of this technique. Methods We enrolled achalasia patients within the time period November 2013 to July 2016 who underwent HRM and evaluation of Eckardt scores (ES) before and after tailored laparoscopic myotomy and fundoplication with intraoperative recording using HRM. Results Twenty patients were classified as having achalasia type I (20%), type II (55%), or type III (25%). During surgery, 9 myotomies were extended and 13 fundoplications were modified according to HRM findings. Mean resting (16.1 vs. 41.9 mmHg) and residual (9 vs. 28.7 mmHg) pressures of the lower esophageal sphincter and ES (0.7 vs. 6.9) were significantly eliminated postoperatively over a mean follow-up time of 17.7 months. Conclusions The use of intraoperative HRM gives us the advantage of simultaneous real-time estimation of intraluminal pressures of the esophagus and the ability to identify the exact points that produce pressure during laparoscopy. Consequently, it may be the key to the tailoring of the Heller-Dor technique and improving the outcomes for achalasia patients. © 2019 Hellenic Society of Gastroenterology.
Συγγραφείς:
Triantafyllou, T.
Theodoropoulos, C.
Georgiou, G.
Kalles, V.
Chrysikos, D.
Filis, K.
Zografos, G.
Theodorou, D.
Περιοδικό:
Annals of Gastroenterological Surgery
Εκδότης:
Hellenic Society of Gastroenterology
Λέξεις-κλειδιά:
adolescent; adult; aged; Article; clinical article; clinical evaluation; disease classification; esophagus achalasia; female; follow up; human; intraoperative period; laparoscopic surgery; lower esophagus sphincter pressure; male; manometry; myotomy; postoperative period; prospective study; scoring system; stomach fundoplication; treatment outcome
DOI:
10.20524/aog.2018.0326
