الفهرس | Only 14 pages are availabe for public view |
Abstract In this study, we aimed to assess esophageal dilatation before surgery as a risk factor for esophageal mucosal injuries during laparoscopic Heller’s cardiomyotomy. This prospective study was conducted at tertiary care hospital at Ain Shams University hospitals from July 2019 till June 2021 and performed on total 20 patients who diagnosed with esophageal achalasia achalasia undergoing Heller’s cardiomyotomy. The current study revealed that there was no statistically significant difference between previous dilatation group among age, sex and BMI while there was statistically significant difference among duration of disease found higher in previous dilatations group. Our study results revealed that there was no statistically significant difference among the studied groups regarding type of achalasia and preoperative Lower Esophageal Sphincter Pressure. Our results revealed that there was significant higher operative time among previous dilatations group than the No previous dilatations group with no statistically significant difference among the studied groups regarding postoperative wound infection, intraoperative bleeding and postoperative hospital stay. Regarding complications, our results revealed that there was no statistically significant difference among the studied groups regarding postoperative reflux esophagitis and perforation. Our results revealed highly significant difference between the preoperative and postoperative eckardt scores among the same group with p-value = 0.007 in the No previous dilatations group and p-value = 0.003 in the previous dilatations group while there was no statistically significant difference found between the studied groups regarding preoperative and postoperative eckardt scores. We concluded that previous esophageal dilatation is not a risk factor for mucosal injury during Laparoscopic Heller Myotomy for Achalasia. Laparoscopic Heller’s cardiomyotomy achieved symptomatic improvement in all patients regardless of prior PBD, and preoperative PBD did not affect the incidence of residual symptoms, necessity of additional postoperative treatments, occurrence of symptomatic GERD or intraoperative mucosal perforation. |