Purposes: Find out advantages of Laparoscopic Heller’s Cardiomyotomy & how to give better surgical outcomes by adding an antireflux procedure.
Background: Achalasia cardia is progressive in nature & don’t have any definitive cure. Esophageal cardiomytomy forms the backbone of the treatment. Over a period of last few years; minimal access surgery is gaining popularity as primary modality of achalasia management.
Patients and methods: The study included 36 patients; 7 (19.5%) ≤ 20years old, 24 (66.8%) between 20-35 years old and 5 (13.8%) above 35 years old. All patients underwent clinical evaluation, laboratory assessment, upper GIT Endoscopy & Esophageal manometry. All patients undergoing laparoscopic cardiomytomy; followed by either a modified Toupet fundoplication (270° posterior fundoplication, or a Dor fundoplication (180° anterior fundoplication).
Results: There was satisfactory relief of Dysphagia in all surgery performed (P-Value =0.011); but low incidence of postoperative reflux was noticed only in modified Toupet fundoplication (P-Value |
