Volume : 4, Issue : 11, November - 2015

LAPAROSCOPIC CARDIOMYOTOMY IN MANAGEMENT OF ACHALASIA AND ITS OUTCOMES.

Dr. Vishal S. Parmar, Dr. Govardhan S. Vaghasiya

Abstract :

<p>Introduction: Achalasia cardia is characterized by aperistalsis in the body of the esophagus coupled with inadequate relaxation of the lower esophageal sphincter, leading to the development of progressive dysphagia. Surgical treatment in the form of laparoscopic Heller&rsquo;s cardiomyotomy with the addition of partial fundoplication procedure like anterior Dor fundoplication is being preferred as the treatment of choice for this condition. Aims and objectives: To Assess the outcome of Laparoscopic Hellers Cardiomyotomy with respect to: 1) Subjective: Improvement in symptomatology 2) Objective: Changes in LES pressure 3) Change in Quality of Life Materials and Method: This prospective study was carried out at the Department of General Surgery at P.D.U. Medical College, Rajkot. 15 patients were included in the study. The main chief complains included were dysphagia, regurgitation, heartburns, etc. They had undergone pre-operative investigations in form of barium swallow, upper GI-endoscopy, manomerty apart from the routine basic investigations. Proper counseling and written and informed consent were taken into account before proceeding for the operation. Standard laparoscopic hellers cardiomyotomy was done along with dor fundoplication. Results: Post-operatively results were assessed and compared according to relief or continuation of symptoms, upper GI-scopy, Manometry findings and Quality of life index calculated by the Modified SF-36 Score. It was noted that there was improvement both subjectively and objectively. Conclusion: Laparoscopic cardiomyotomy is safe with beneficial outcomes for treatment of achalasia so as to be considered as a gold standard.</p>