caa a22 4500 467951004 CHVBK 20180405193742.0 cr unu---uuuuu 170328e20041101xx s 000 0 eng 10.1007/s00464-004-8912-z doi (NATIONALLICENCE)springer-10.1007/s00464-004-8912-z (NATIONALLICENCE)springer-10.1007/BF02637121 Results of laparoscopic Heller-Toupet operation for achalasia [Elektronische Daten] [J. Perrone, M. Frisella, K. Desai, N. Soper] Background: Laparoscopic myotomy has become the preferred treatment for achalasia. Controversy persists on the need for fundoplication and/or its type; when used, most series have utilized the Dor fundoplication. We report a large series of laparoscopic Heller-Toupet procedures. Methods: All patients operated for achalasia were entered into a prospective database. Pre and postoperative esophageal symptoms, satisfaction scores, and SF-36 variables were compared. Surgical failures were defined as recurrent or persistent dysphagia leading to secondary treatment. Data are expressed as mean ± S.D. Results: One hundred consecutive cases were analyzed (61 men, 39 women, age 47 ± 17yr). Heller-Toupet was performed in 94, whereas six patients had a Dor fundoplication because of mucosal perforation (three) or technical difficulties performing a posterior wrap (three). Operative time was 148 ± 21min. There were 13 intraoperative adverse events managed laparoscopically, and no conversions. Minor postoperative complications were noted in two cases, whereas there were no major complications or deaths. Mean hospital stay was 1.2 ± 0.5 days, (range 1-4). Follow-up was complete in 92% at 26 ± 17 months. Failures leading to further treatment occurred in 4%. All symptom scores were significantly improved (p < 0.0001). Solid dysphagia score went from 6.4 to 1.0 postoperatively; regurgitation score went from 4.5 to 0.2 (combined frequency and severity, range 0-8). Postoperative global esophageal symptoms scale revealed improvement in 97%, and all domains of the SF-36 were improved. Conclusions: Although the best surgical approach to achalasia is yet to be determined, laparoscopic Heller-Toupet operation in experienced hands is a safe and effective procedure with low rates of morbidity and failure and high patient satisfaction. Springer-Verlag, 2004 Achalasia nationallicence Laparoscopy nationallicence Heller-Toupet operation nationallicence Perrone J. Washington University Institute for Minimally Invasive Surgery, 660 S Euclid, Box 8109, 63110, St. Louis, MO, USA aut Frisella M. Washington University Institute for Minimally Invasive Surgery, 660 S Euclid, Box 8109, 63110, St. Louis, MO, USA aut Desai K. Washington University Institute for Minimally Invasive Surgery, 660 S Euclid, Box 8109, 63110, St. Louis, MO, USA aut Soper N. Northwestern University Feinberg School of Medicine, Galter 10-105, 201 E. Huron, 60611, Chicago, IL, USA aut Surgical Endoscopy And Other Interventional Techniques Springer-Verlag; www.springer-ny.com 18/11(2004-11-01), 1565-1571 0930-2794 18:11<1565 2004 18 464 https://doi.org/10.1007/s00464-004-8912-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00464-004-8912-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Perrone J. Washington University Institute for Minimally Invasive Surgery, 660 S Euclid, Box 8109, 63110, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Frisella M. Washington University Institute for Minimally Invasive Surgery, 660 S Euclid, Box 8109, 63110, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Desai K. Washington University Institute for Minimally Invasive Surgery, 660 S Euclid, Box 8109, 63110, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Soper N. Northwestern University Feinberg School of Medicine, Galter 10-105, 201 E. Huron, 60611, Chicago, IL, USA aut NATIONALLICENCE 773 0- Surgical Endoscopy And Other Interventional Techniques Springer-Verlag; www.springer-ny.com 18/11(2004-11-01), 1565-1571 0930-2794 18:11<1565 2004 18 464 NATIONALLICENCE 856 40 https://doi.org/10.1007/BF02637121 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Perrone J. Washington University Institute for Minimally Invasive Surgery, 660 South Euclid, Box 8109, 63110, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Frisella M. Washington University Institute for Minimally Invasive Surgery, 660 South Euclid, Box 8109, 63110, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Desai K. Washington University Institute for Minimally Invasive Surgery, 660 South Euclid, Box 8109, 63110, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Soper N. Northwestern University Feinberg School of Medicine, Galter 10-105, 201 East Huron, 60611, Chicago, IL, USA aut NATIONALLICENCE 773 0- Surgical Endoscopy And Other Interventional Techniques Springer-Verlag 18/11(2004-11-01), 1565-1571 0930-2794 18:11<1565 2004 18 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE NATIONALLICENCE NL-springer