Role of modified Glasgow Prognostic Score in patients with achalasia who underwent laparoscopic Heller-myotomy with Dor-fundoplication

• Published in: Esophagus : official journal of the Japan Esophageal Society Vol. 21; no. 3; pp. 374 - 382
• Main Authors: Fukushima, Naoko, Masuda, Takahiro, Tsuboi, Kazuto, Hoshino, Masato, Takahashi, Keita, Yuda, Masami, Sakashita, Yuki, Takeuchi, Hideyuki, Omura, Nobuo, Yano, Fumiaki, Eto, Ken
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.07.2024; Springer Nature B.V
• Subjects: Adult; Aged; Esophageal Achalasia - diagnosis; Esophageal Achalasia - surgery; Female; Fundoplication - adverse effects; Fundoplication - methods; Gastroenterology; Heller Myotomy - adverse effects; Heller Myotomy - methods; Humans; Laparoscopy; Laparoscopy - methods; Male; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Original Article; Postoperative Complications - epidemiology; Prognosis; Retrospective Studies; Severity of Illness Index; Surgical Oncology; Surgical outcomes; Thoracic Surgery; Treatment Outcome; Esophagitis; Achalasia; Systemic inflammatory response; Laparoscopic Heller‑myotomy with Dor‑fundoplication; Modified Glasgow Prognostic Score
• ISSN: 1612-9059; 1612-9067; 1612-9067
• DOI: 10.1007/s10388-024-01047-x

Background Systemic inflammatory response is significant prognostic indicator in patients with various diseases. The relationship between prognostic scoring systems based on the modified Glasgow Prognostic Score (mGPS) and achalasia in patients treated with laparoscopic Heller‑myotomy with Dor‑fundoplication (LHD) remains uninvestigated. This study aimed to examine the role of mGPS in patients with achalasia. Methods 457 patients with achalasia who underwent LHD as the primary surgery between September 2005 and December 2020 were included. We divided patients into the mGPS 0 and mGPS 1 or 2 groups and compared the patients’ background, pathophysiology, symptoms, surgical outcomes, and postoperative course. Results mGPS was 0 in 379 patients and 1 or 2 in 78 patients. Preoperative vomiting and pneumonia were more common in patients with mGPS of 1 or 2. There were no differences in surgical outcomes. Postoperative upper gastrointestinal endoscopy revealed that severe esophagitis was more frequently observed in patients with mGPS of 1 or 2 ( P  < 0.01). The clinical success was 91% and 99% in the mGPS 0 and mGPS 1 or 2 groups, respectively ( P  < 0.01). Conclusions Although severe reflux esophagitis was more common in patients with achalasia with a high mGPS, good clinical success was obtained regardless of the preoperative mGPS.