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|Title:||Laparoscopic cardiomyotomy and Dor patch for achalasia|
|Citation:||Canadian Journal of Surgery, 1995; 38(5):445-448|
|Publisher:||Canadian Medical Association|
|Philip C. Mitchell; David I. Watson, P.G. Devitt, R. Britten-Jones, S. MacDonald, MD; J.C. Myers, Glyn G. Jamieson|
|Abstract:||Objective: To evaluate early experience with laparoscopic Heller's cardiomyotomy with placement of a Dor patch for achalasia. Design: A prospective case series. Setting: A university teaching hospital. Patients: Fourteen patients (5 men, 9 women, median age 47 years) with esophageal achalasia, treated between July 1992 and July 1994. Interventions: Laparoscopic Heller's cardiomyotomy with a Dor patch. Main Outcome Measures: Clinical relief of symptoms, confirmed by esophageal manometry, 24-hour ambulatory pH monitoring and barium-contrast radiography. Results: Three of the 14 patients required conversion to an open procedure, and 1 underwent early laparotomy for postoperative bleeding. The median operating time was 120 minutes (range from 75 to 210 minutes), and the median duration of hospitalization was 4 days (range from 3 to 18 days). Normal physical activity was resumed after a median of 2 weeks (range from 0.5 to 6 weeks). Symptomatic dysphagia was completely relieved in 12 patients and improved in 2. Only one patient experienced symptoms of reflux postoperatively. Postoperative esophageal manometry (seven patients), 24-hour pH monitoring (five patients) and barium-meal radiography (seven patients) confirmed the clinical results. Conclusion: Laparoscopic Heller's cardiomyotomy with a Dor patch provides a viable alternative to open cardiomyotomy and forceful endoscopic dilatation.|
|Keywords:||Esophagus; Cardia; Humans; Esophageal Achalasia; Postoperative Complications; Laparoscopy; Length of Stay; Methods; Middle Aged; Female; Male|
|Rights:||© Copyright 1995-2012 Canadian Medical Association.|
|Appears in Collections:||Surgery publications|
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