BACKGROUND: The present report summarizes 12 cases with achalasia treated with laparoscopic Heller myotomy and anterior fundoplication according to the method of Thal and Dor. PATIENTS AND METHODS: From 1997 to 2005 at 2 institutions in Europe, 12 patients (7 male and 5 female, ages ranging from 3.5 to 7 years) were treated for esophageal achalasia (EA) with laparoscopic Heller myotomy and anterior fundoplication according to Thal and Dor. In 1 case a perforation of the esophageal mucosa occurred, which was promptly treated during surgery. Follow-up ranged from 18 to 60 months and included clinical examination and barium radiography of the upper digestive tract. RESULTS: Postoperatively, 10 patients showed a normal weight curve and complete resolution of symptoms. All patients showed complete regression of digestive and respiratory symptoms from the first examination, with a normal oral meal intake and an improvement of weight and height parameters. One case required repeat intervention after 2 years because of persisting pain; in this case surgery revealed an insufficient myotomy. CONCLUSIONS: Modified extramucosal Heller cardiomyotomy associated with 180° anterior antireflux plastic surgery (according to Thal and Dor's procedures) is a useful and safe procedure in the treatment of EA in pediatric patients. Our data, which are supported by long-term follow-up, also stress the relevance of anterior fundoplication in preventing postoperative gastroesophageal reflux. © 2007 Lippincott Williams & Wilkins, Inc.
Garzi, A., Valla, J.S., Molinaro, F., Amato, G., Messina, M. (2007). Minimally invasive surgery for Achalasia: combined experience of two European Centers. JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION, 44(5), 587-591 [10.1097/MPG.0b013e318032062f].
Minimally invasive surgery for Achalasia: combined experience of two European Centers
Molinaro, Francesco;Messina, Mario
2007-01-01
Abstract
BACKGROUND: The present report summarizes 12 cases with achalasia treated with laparoscopic Heller myotomy and anterior fundoplication according to the method of Thal and Dor. PATIENTS AND METHODS: From 1997 to 2005 at 2 institutions in Europe, 12 patients (7 male and 5 female, ages ranging from 3.5 to 7 years) were treated for esophageal achalasia (EA) with laparoscopic Heller myotomy and anterior fundoplication according to Thal and Dor. In 1 case a perforation of the esophageal mucosa occurred, which was promptly treated during surgery. Follow-up ranged from 18 to 60 months and included clinical examination and barium radiography of the upper digestive tract. RESULTS: Postoperatively, 10 patients showed a normal weight curve and complete resolution of symptoms. All patients showed complete regression of digestive and respiratory symptoms from the first examination, with a normal oral meal intake and an improvement of weight and height parameters. One case required repeat intervention after 2 years because of persisting pain; in this case surgery revealed an insufficient myotomy. CONCLUSIONS: Modified extramucosal Heller cardiomyotomy associated with 180° anterior antireflux plastic surgery (according to Thal and Dor's procedures) is a useful and safe procedure in the treatment of EA in pediatric patients. Our data, which are supported by long-term follow-up, also stress the relevance of anterior fundoplication in preventing postoperative gastroesophageal reflux. © 2007 Lippincott Williams & Wilkins, Inc.File | Dimensione | Formato | |
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https://hdl.handle.net/11365/9929
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