Khirurgiia · 2022
[Effectiveness of laparoscopic esophagocardiomyotomy combined with various modifications of fundoplication in the treatment of achalasia cardia].
Аннотация на английскомСтатьяНазвание и аннотация: Оригинал на русском
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Allakhverdyan A S, Anipchenko A N, Anipchenko N N
Аннотация
OBJECTIVE: To analyze the results of laparoscopic esophagocardiomyotomy with original fundoplication and Dor fundoplication.
MATERIAL AND METHODS: Laparoscopic esophagocardiomyotomy with fundoplication was performed in 196 patients with achalasia cardia. Patients with achalasia stage 2 comprised 48.5% (95/196), stage 3 - 51.5% (101/196). Two groups were distinguished depending on surgery: Dor fundoplication (group 1, n=53) and Allakhverdyan fundoplication (group 2, n=143). Statistical analysis of data was carried out.
RESULTS: Surgery time in the first group was longer by 35 minutes (p=0.000), blood loss - by 30 ml (p=0.000), postoperative hospital-stay - by 3 days. Pulmonary complications occurred in 34% and 2% of patients, respectively (p=0.002). In the first group, reflux esophagitis in 3 months after surgery was found in 62% of patients, after 6 months - 72%, after a year - in 74% of patients. In the second group, these values were 24%, 8% and 3%, respectively. Dysphagia developed in 2% and 1% of cases, respectively (p=0.767).
CONCLUSION: Dor fundoplication demonstrates unsatisfactory long-term results and should be currently considered as historical stage in surgical treatment of achalasia cardia.
MATERIAL AND METHODS: Laparoscopic esophagocardiomyotomy with fundoplication was performed in 196 patients with achalasia cardia. Patients with achalasia stage 2 comprised 48.5% (95/196), stage 3 - 51.5% (101/196). Two groups were distinguished depending on surgery: Dor fundoplication (group 1, n=53) and Allakhverdyan fundoplication (group 2, n=143). Statistical analysis of data was carried out.
RESULTS: Surgery time in the first group was longer by 35 minutes (p=0.000), blood loss - by 30 ml (p=0.000), postoperative hospital-stay - by 3 days. Pulmonary complications occurred in 34% and 2% of patients, respectively (p=0.002). In the first group, reflux esophagitis in 3 months after surgery was found in 62% of patients, after 6 months - 72%, after a year - in 74% of patients. In the second group, these values were 24%, 8% and 3%, respectively. Dysphagia developed in 2% and 1% of cases, respectively (p=0.767).
CONCLUSION: Dor fundoplication demonstrates unsatisfactory long-term results and should be currently considered as historical stage in surgical treatment of achalasia cardia.