Surgical treatment of achalasia cardia in Tikur Anbessa Hospital, Ethiopia.

OBJECTIVE

This review aims to evaluate 61 patients with achalasia cardia treated with Heller's cardiomyotomy in Tikur Anbessa Hospital (TAH).

METHODS

A hospital based cross sectional analysis was conducted in TAH, Department of Surgery, Addis Ababa, Ethiopia between January 1996 and December 2005. Medical records and operation theater registers of 61 patients operated upon for achalasia cardia were analyzed retrospectively.

RESULTS

Thirty-four were male and twenty-seven female with mean age of 25 years (range 9-58). All had dysphagia to solid foods. Thirty-one (50.8%) patients had weight loss. The diagnosis of achalasia cardia was confirmed in 60 (98.4%) patients by barium swallow; in 23/25 (92.0%) by esophagoscopy. Cardiomyotomy was performed through transabdominal (83.6%) and transthoracic (16.4%) approaches. Immediate postoperative course was uneventful in 52 (85.2%) patients, while 9 (14.8%) patients developed immediate postoperative complication. There was no in-hospital mortality. Median operation time and hospital stay were 60 minutes and 7 days respectively. Late complications occurred in 7/52 (13.5%) patients, Gastroesophageal Reflux Disease (GERD) (9.6%) being the most common. A very good palliation of dysphagia was achieved in 88.5% of cases (p < 0.0001).

CONCLUSION

Significant improvement in dysphagia of patients with achalasia cardia following modified Heller's myotomy alone is possible in majority of the patients.