THE EFFICACY OF LAPAROSCOPIC HELLER’S MYOTOMY IN ACHALASIA PATIENTS-A UNIVERSITY HOSPITAL EXPERIENCE

Abstract

Objectives: To determine the impact of Laparoscopic Heller Myotomy on patient’s symptoms by evaluating pre-operative and post-operative Eckardt's score.

Method: The patients involved in this study were diagnosed with Achalasia and underwent Laparoscopic Heller Myotomy between 2008 and 2015 at King Saud University Medical City Saudi Arabia. A twenty five patients who underwent LHM were reviewed. Finally, 19 patients who met the inclusion criteria were included to conduct a retrospective cohort designed study. Patient’s demographic data, time of admission, hospital stay, and surgical complications were obtained through HospitaI Information System (HIS). Clinical symptoms were assessed using the Eckardt’s score which is the sum of the individual symptom score for dysphagia, regurgitation, and retrosternal pain and weight loss. The pre-operative score was collected before the time of the surgery in the surgical clinic. The post-operative score was collected by contacting the patient via telephone. The post-operative Eckardt’s score has been taken in two time periods. First 3 to 6 months after the surgery and second, at the time of the call (January 2016).

Results: A total of 19 patients were included, with a mean age of 36.6 years and 68.4% of them were males. The mean of the pre-surgical Eckardt score was 6.2 which dropped to (1.3, 2.5) after Laparoscopic HeIIer Myotomy (P<0.01) with clinical remission of 84.2% after the surgery and a total failure in 3 patients (15.2%) after the surgery.

Conclusion: Laparoscopic HeIIer Myotomy is an effective procedure in AchaIasia patients with clinical remission of 84.2%.

KEYWORDS: AchaIasia, HeIIer myotomy, Esophagus, Eckdart score.