Authors: S Rakita D Villadolid C Kalipersad D Thometz A Rosemurgy
Publish Date: 2007/04/14
Volume: 21, Issue: 10, Pages: 1709-1714
Abstract
Heller myotomy is accepted as firstline therapy for achalasia yet for a small number of patients symptoms persist or recur after myotomy This study was undertaken to report our results with reoperative laparoscopic Heller myotomy for recurrent symptoms of achalasiaWe have undertaken laparoscopic Heller myotomy in 275 patients and reoperative myotomy in 12 patients for recurrent dysphagia of which three had their initial myotomy undertaken by us For each studies prior to reoperative Heller myotomy documented a nonrelaxing lower esophageal sphincter without stricture Patients scored symptoms before and after reoperative myotomyBefore reoperative myotomy 75 underwent dilation and 42 underwent Botox injection Ten of twelve reoperative myotomies were undertaken and completed laparoscopically Median followup is 241 months 290 months + 2589 Symptom frequency and severity scores improved significantly after reoperative myotomy Frequency of vomiting and frequency and severity of heartburn were improved after reoperative myotomy but not to a significant extent However they were not particularly notable prior to surgery compared to obstructive symptoms such as dysphagia Excellent or good outcomes were reported in 73 and notably 91 stated that they would have the operation again after having been through the process firsthand and knowing their outcomes
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