Open Vs Laparoscopic Heller Myotomy in Management of Achalasia Cardia, Retrospective Analysis of 75 Cases

Abstract

Objective: To compare open transabdominal heller myotomy and Laparoscopic heller myotomy in terms of symptom control, safety and quality of life.

Methodology: Patients with a diagnosis of achalasia cardia who underwent open as well as laparoscopic Heller myotomy were included in the study. A record of all these patients, including age, sex, symptoms, diagnosis and details of surgery, postoperative results and follow-up, was made. Patients were divided into two groups and compared in terms of symptomatic control and quality of life.

Results Out of 75 patients, 33 were included in Group A (Open approach) and 42 in Group B (laparoscopic approach). The mean age of the patients was 33.82 + 5.37 years with age ranging from 25 to 47 years. Most common symptom was dysphagia which was present in 100% of patients followed by weight loss which occurred in 83.58% of patients. Mean operative time in Group A was 60.00 + 6.08 minutes, while in Group B it was 45.43 + 7.07 minutes (p=.000). Overall, 8 (12.30%) complications occurred in the study population, which was intraoperative mucosal injury. Over a follow-up period of 6 months, 30 (92.90%) in Group A were satisfied with the results, having no dysphagia or regurgitation, while in Group B, 39 (92.85%) had satisfactory results.

Conclusion: Laparoscopic Heller myotomy is a safe alternative approach used for the treatment of achalasia cardia as compared to the open approach in terms of symptomatic control and better quality of life.

Keywords: Achalasia Cardia, Fundoplication, Heller Myotomy, Motility disorder