Laparoscopic Heller Myotomy With EGD and Balloon Dilation: A Durable Solution for Achalasia

• Published in: The American surgeon Vol. 89; no. 6; p. 2445
• Main Authors: Zambetti, Benjamin R, Murphy, William G, Craner, Domenic, Wong, Denise L, Pettigrew, Benjamin D, Webb, David L, Voeller, Guy R, Stoikes, Nathaniel F N
• Format: Journal Article
• Language: English
• Published: United States 01.06.2023
• Subjects: balloon dilation; heller myotomy; achalasia
• ISSN: 1555-9823
• DOI: 10.1177/00031348221101473

Laparoscopic Heller myotomy (LHM) and esophageal balloon dilation (BD) are the two mainstays of achalasia treatment-this study examines the outcomes when they are performed simultaneously without fundoplication. All patients undergoing LHM&BD were reviewed for demographic and procedural data, and to see if additional procedures for achalasia had been performed. Patients were surveyed using the Eckardt score and the GERD quality-of-life score (GERD-HRQL) to assess the durability of repair. From 2013-2020, 66 patients underwent LHM&BD. There were no esophageal perforations and a median LOS of 1 day. Seven patients have required additional operations or procedures at median 4-years follow up. 31 patients (47%) responded to the survey. The average Eckardt score was 2.9 (goal<4) with mean GERD-HRQL of 14.4 (goal<25). LHM&BD allows for a safe, durable repair of achalasia. Reflux symptoms are manageable with PPI without fundoplication and the re-intervention rate similar to published values.