Background. One of the most common surgical treatment methods of achalasia of the cardia (AC) is Geller esophagocardiomyotomy. To prevent the reflux esophagitis in the postoperative period, Geller’s cardiomyotomy and Dor’s fundoplication were combined.
OBJECTIVE
The aim of study was to assess the presence and severity of reflux esophagitis after Geller’s videolaparoscopic esophagocardiomyotomy with Dor’s fundoplication in patients with 2—4 stages of achalasia.
MATERIAL AND METHODS
The results of fibrogastroduodenoscopy, 24-hour intraesophageal pH-test and questionnaire survey of patients according to the GERD-HRQL questionnaire (gastroesophageal reflex disease health related quality of life scale) of 98 patients were analyzed.
RESULTS
According to the results of fibrogastroduodenoscopy in the postoperative period, the erosive and fibrinous esophagitis were stopped in all the studied groups, the frequency of catarrhal esophagitis decreased by 75.4%. According to the results of 24-hour intraesophageal pH-test before surgery, no cases of pathological reflux were detected in patients. After surgery, the percentage (%) of total time with pH <4 and the number of GER with pH <4 in all groups did not exceed the norm (4.5 and 46.9, respectively). The DeMeester index in the lower third of the esophagus (l/th) before and after surgery did not exceed normal values of less than 14.72 (respectively 4.6±0.8 and 3.02±0.6). Data from the GERD-HRQL questionnaire showed an improvement in the well-being of patients after surgery, a decrease in the amount of points scored by 64.9% compared with preoperative data (respectively 14.8±0.5 and 5.2±0.5).
CONCLUSION
Heller’s myotomy, supplemented by fundoplication by Dor’s as an antireflux procedure, is accompanied by a minimal risk of developing reflux esophagitis in the postoperative period.
