Effects of preoperative endoscopic pneumatic balloon dilatation on postoperative achalasia symptoms after Heller esophageal myotomy plus Dor fundoplication
Twenty four patients who underwent laparoscopic Heller without fundoplication had greater improvement in esophageal clearance time than did 71 patients whose procedure included a Dor fundoplication as studied by Finley and colleagues15 there were no significant differences in the symptom scores for dysphagia, regurgitation, or heartburn between the two groups postoperatively.
Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: a prospective randomized double-blind clinical trial.
Treatments include balloon dilation and Heller myotomy with Dor fundoplication
In 2007 an elective laparoscopic Heller myotomy (approximately 5 cm anterior myotomy) with Dor fundoplication was performed without complication.
At surgery, it was clear that the previous myotomy had not extended onto the stomach and therefore did not disrupt the LES as desired, additionally the Dor fundoplication created a secondary esophageal obstruction in an immotile esophagus making food transit impossible.
We have followed laparoscopic Heller's myotomy (LHM) alone in the early part of the series and later added an anterior partial Dor fundoplication
Holzman et al., "Heller myotomy versus heller myotomy with dor fundoplication
for achalasia: a prospective randomized double-blind clinical trial," Annals of Surgery, vol.
(12,13) Fewer complications have been encountered with the Dor fundoplication
compared with other antireflux procedures.
after myotomy for achalasia: useful, unnecessary, or harmful?
Heller myotomy versus Heller myotomy with Dor fundoplication
for achalasia: long-term symptomatic follow-up of a prospective randomized controlled trial.
With short hospital stay and cost effectiveness combination of Heller's myotomy and Dor fundoplication
is a formidable option for treatment of achalasia cardia since it can be performed by general surgeons with minimal experience, it does not require lung ventilation.