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Del Grande et al. Myotomy in end stage achalasia

Table 1: Results for laparoscopic Heller’s myotomy in patients with end-stage achalasia
Follow-up Good and excellent results for
Author n Mortality (%)
(months) dysphagia relieve (%)
[6]
Patti et al. 1999 19 NR 0 91.5
Herbella et al. 1999 12 40 0 97.6
[38]
[39]
Faccani et al. 2007 33 89 0 69.7
[40]
Mineo and Pompeo 2004 14 85 0 72
[41]
Gaissert et al. 2006 12 154 0 54
[31]
Schuchert et al. 2008 22 31.6 0 NR
[42]
Sweet et al. 2008 12 45 0 91
[43]
Scott et al. 2009 4 NR 0 100
[44]
Shuchert et al. 2009 24 30.5 0 62.5
[9]
Pantanali et al. 2013 11 31.5 0 72.8
Average 16 83 0 79.3
NR: not reported
mediastinal esophagus allows a straightening of the Conflicts of interest
axis of the organ facilitating esophageal emptying [42,44] . There are no conflicts of interest.
Finally, LHM does not preclude a subsequent Patient consent
reoperation with a different technique. Recurrent Not applicable.
dysphagia after LHM may be treated by endoscopic
dilatation [50] , POEM [50,51] , redo LHM [50] , cardioplasty with Ethics approval
or without gastrectomy [33,34,36] , or esophagectomy [10,50] .
If a bigger operation is needed, the patient would need Not applicable.
a better overall clinical and nutritional status.
REFERENCES
CONCLUSION
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The procedure is associated with a low rate of Esophagus 2012;25:305-10.
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of patients. LHM is not technically more demanding of idiopathic achalasia and Chagas’ disease esophagopathy at the light
and it does not preclude a subsequent reoperation of high-resolution manometry. Dis Esophagus 2014;27:128-33.
with a different technique if necessary. 4. Herbella FA, Oliveira DR, Del Grande JC. Are idiopathic and Chagasic
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Authors’ contributions 6. Patti MG, Feo CV, Diener U, Tamburini A, Arcerito M, Safadi B, Way
Acquisition of data, drafting the article, analysis and LW. Laparoscopic Heller myotomy relieves dysphagia in achalasia
interpretation of data, final approval of the version to when the esophagus is dilated. Surg Endosc 1999;13:843-7.
be published: L.M. Del Grande 7. Onopriev VI, Durleshter VM, Ryabchun VV. Comparative pre- and
Conception and design, acquisition of data, analysis postoperative results analysis of functional state of the esophagus
assessment in patients with various stages of achalasia. Eur J
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published: M.G. Patti 9. Pantanali CA, Herbella FA, Henry MA, Mattos Farah JF, Patti MG.
Acquisition of data, final approval of the version to be Laparoscopic Heller myotomy and fundoplication in patients with
published: F. Schlottmann Chagas' disease achalasia and massively dilated esophagus. Am Surg
2013;79:72-5.
Financial support and sponsorship 10. Yaghoobi M, Mayrand S, Martel M, Roshan-Afshar I, Bijarchi
R, Barkun A. Laparoscopic Heller’s myotomy versus pneumatic
None. dilation in the treatment of idiopathic achalasia: a meta-analysis of
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