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Laparoscopic Heller-Dor Is an Effective Treatment for Esophageal-Gastric Junction Outflow Obstruction
- Source :
- Journal of Gastrointestinal Surgery. 25:2201-2207
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Background The treatment of esophagogastric junction outflow obstruction (EGJOO) currently mirrors that of achalasia, but this is based on only a few studies on small case series. The aim of this prospective, controlled study was to assess the outcome of laparoscopic Heller-Dor (LHD) in patients with EGJOO, as compared with patients with esophageal achalasia. Materials and Methods Between 2016 and 2019, patients with manometric diagnosis of idiopathic EGJOO and patients with radiological stage I achalasia, both treated with LHD, were compared. The achalasia group was further analyzed by subgrouping the patients based on the manometric pattern. Treatment failure was defined as the persistence or reoccurrence of an Eckardt score > 3 or the need for retreatment. Results During the study period, 150 patients were enrolled: 25 patients had EGJOO and 125 had radiological stage I achalasia (25 pattern I, 74 pattern II, and 26 pattern III). The median follow-up was 24 months (IQR: 34–16). Treatment was successful in 96% of patients in the EGJOO group and in 96% of achalasia patients with pattern I, 98.7% in those with pattern II, and 96.2% of those with pattern III (p=0.50). High-resolution manometry showed a reduction in the LES resting pressure and integrated relaxation pressure for all patients in all 4 groups (p Conclusion This is the first comparative study based on prospective data collection to assess the outcome of LHD in patients with EGJOO. LHD emerged as an effective treatment for EGJOO, with an excellent success rate, comparable with the procedure’s efficacy in treating early-stage achalasia.
- Subjects :
- medicine.medical_specialty
Manometry
EGJOO
Prospective data
Achalasia
Treatment failure
03 medical and health sciences
0302 clinical medicine
Heller-Dor
medicine
Humans
Effective treatment
High-resolution manometry
In patient
Esophagogastric junction
High resolution manometry
business.industry
Gastroenterology
medicine.disease
Surgery
Esophageal Achalasia
Treatment Outcome
030220 oncology & carcinogenesis
Laparoscopy
030211 gastroenterology & hepatology
Esophagogastric Junction
business
Subjects
Details
- ISSN :
- 18734626 and 1091255X
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Journal of Gastrointestinal Surgery
- Accession number :
- edsair.doi.dedup.....20ea8ed240916ae17be0f8abbee7cee7