Features and results of minimally invasive treatment of recurrent achalasia

Gallyamov E.A.; Erin S.A.; Gololobov G.Yu.; Burmistrov A.I.; Chicherina M.A.; Rikunova A.A.

doi:https://doi.org/10.17116/hirurgia202203116

Gallyamov E.A.

Sechenov First Moscow State Medical University

Erin S.A.

The city clinical hospital named after S.I. Spasokukotsky

Gololobov G.Yu.

Sechenov First Moscow State Medical University

ORCID: 0000-0001-9279-8600

Burmistrov A.I.

Evdokimov Moscow State University of Medicine and Dentistry

Chicherina M.A.

Sechenov First Moscow State Medical University

Rikunova A.A.

Sechenov First Moscow State Medical University

Features and results of minimally invasive treatment of recurrent achalasia

Authors:

Gallyamov E.A., Erin S.A., Gololobov G.Yu., Burmistrov A.I., Chicherina M.A., Rikunova A.A.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2022;(3): 16‑22

DOI: 10.17116/hirurgia202203116

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To cite this article:

Gallyamov EA, Erin SA, Gololobov GYu, Burmistrov AI, Chicherina MA, Rikunova AA. Features and results of minimally invasive treatment of recurrent achalasia. Pirogov Russian Journal of Surgery. 2022;(3):16‑22. (In Russ.)
https://doi.org/10.17116/hirurgia202203116

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

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Abstract:

OBJECTIVE

To evaluate the early and long-term postoperative outcomes in patients with recurrent achalasia, as well as the main features of surgical treatment.

MATERIAL AND METHODS

There were 7 patients (4 men and 3 women) with recurrent achalasia. Mean age of patients was 42.3±13.5 years, body mass index — 22.7±3.3 kg/m². Physiological status ASA grade 1-3 was observed in all patients. Concomitant diseases were diagnosed in 5 (71.4%) cases. Six (85.7%) patients underwent laparoscopic Heller cardiomyotomy with Dor fundoplication. Peroral endoscopic myotomy (POEM) was performed in 1 (14.3%) patient. Mean preoperative Eckardt score was 10.7±1.4 points, mean GERD-HRQL score — 42.7±6.4 points. According to preoperative radiography, 5 (71.4%) patients had achalasia stage III, 2 (28.6%) ones — stage IV.

RESULTS

All patients underwent laparoscopic Heller esophagocardiomyotomy with anterior Dor fundoplication and posterior partial fundoplication with posterior cruroraphy. Intraoperative complications (perforation of esophageal mucosa) occurred in 3 (42.9%) patients. Mean surgery time was 130±56 min, mean blood loss — 37 ml (35-205 ml), mean hospital-stay — 11.3±7.7 days. Postoperative complications Clavien-Dindo grade 3—4 were detected in 1 (14.3%) patient. One patient was diagnosed with bilateral pneumonia (SARS-Cov-2 infection) in 4 postoperative days. Median postoperative follow-up period was 22 months. Mean BMI in 6 months after surgery was 25.3±3.1 kg/m², mean Eckardt score — 2.1±0.7 points, mean GERD-HRQL score — 3.3±0.9 points.

CONCLUSION

Our data confirm the effectiveness and safety of the modified laparoscopic Heller procedure with Dor fundoplication as the main method for recurrent achalasia.

Keywords:

recurrent achalasia

methods of achalasia management

modified laparoscopic Heller cardiomyotomy with Dor fundoplication

Authors:

Gallyamov E.A.

Sechenov First Moscow State Medical University

Erin S.A.

The city clinical hospital named after S.I. Spasokukotsky

Gololobov G.Yu.

Sechenov First Moscow State Medical University

ORCID: 0000-0001-9279-8600

Burmistrov A.I.

Evdokimov Moscow State University of Medicine and Dentistry

Chicherina M.A.

Sechenov First Moscow State Medical University

Rikunova A.A.

Sechenov First Moscow State Medical University

Received:

06.06.2021

Accepted:

10.07.2021

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