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2007, Number 1

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Rev Mex Cir Endoscop 2007; 8 (1)

Heller’s cardiomyotomy through laparoscopic approach: Experience of HGR No. 1, IMSS, Tijuana

Covarrubias HMA, López CJA, Guzmán CF, Jaramillo de la TEJ, Solórzano EA, Barrera ZLM

Language: Spanish
References: 19
Page: 30-34
PDF size: 148.96 Kb.


ABSTRACT

Achalasia is the most frequent pathology among esophageal motor disorders when the selected treatment is surgical. It has been performed since last decade through laparoscopic approach.
Material and methods: Preliminary results from patients having been diagnosed esophageal achalasia are presented here. These results were obtained at the HGR # 1, Tijuana B.C. during the period going from August 2003 to April 2006.
Results: The study considered a total of 13 patients, 7 women and 6 men ranging from ages between 28 to 72 years old. The main symptoms were: dysphagia (100%), regurgitation (60%), weight loss (60%) and thoracic pain (40%). It was performed a Heller’s cardiotomy through blunt dissection of the muscle fibers in the esophagus, with a length of 6 to 8 cm, including 1 cm below the esophageal connection. The surgery was completed by partial fundoplication: 10 patients (77%) Toupet and 3 patients (23%) Dor, from whom two presented a perforation, remaining the fundoplication as a patch. Once the patients were discharged from the hospital, an annual following was practiced. The dysphagia diminished in every case and up to the moment there is no evidence of pathological reflux.
Conclusion: Heller’s cardiomyotomy through laparoscopic approach is the selected treatment for dysphagia secondary to achalasia, and it must be carried out at an institution where enough medical experience and resources can be found and the probable complications can be solved.


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