Laparoscopic Heller Myotomy with Dor Fundoplication for Achalasia: An Outcome in a Tertiary Health Center of Nepal
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Abstract
Introduction: Laparoscopic Heller Myotomy with Dor fundoplication is the most effective therapeutic option for Achalasia cardia, with fewer complications. We present the outcomes of this procedure with long-term follow-up in patients with Achalasia cardia. Methods: A single institution prospectively maintained data of Laparoscopic Heller Myotomy with Dor fundoplication between January 2014 and January 2024 was reviewed. Eckardt scores at three-time points (preoperative, 3-month, and long-term follow-up) were used to assess treatment efficacy.Results: A total of 16 patients had a median age of 34 years. Megaesophagus was observed in 8 (50%) patients, and 5 patients had sigmoid esophagus. The mean operative time was 162 ± 41 minutes. The mean myotomy length was 6.1 cm and 2.19 cm, respectively, for the esophagus and the stomach. Following the surgery, there was significant improvement in the Eckardt score from a median preoperative score of 9 (5 – 12) to a median postoperative score of 2(0 – 4) in 3 months (p=0.001) and a median Eckardt score of 1.5 (0 – 3) in long-term follow-up (P<0.001). The median long-term follow-up was 32 months (12 – 60 months). Overall, two treatment failure was observed, and one required endoscopic balloon dilatation. The gastroesophageal reflux (uncomplicated) was observed in 5 (31.2%) patients. The symptoms were mild, and none had reflux-related complications at the last follow-up. Conclusions: LHM provides immediate and durable symptomatic relief with fewer complications.
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| Authors | Adhikary, Shailesh |
| Journal | Frontiers in surgery |
| Year | Year not found |
| DOI |
10.3389/fsurg.2026.1678605
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| Keywords | Keywords not found |
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