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Study of Treating Achalasia by Transabdominally Performing Augmented Heller with Dor Added

Author: TuoLei
Tutor: ZhangXun
School: Tianjin Medical University
Course: Surgery
Keywords: Abdominal surgery Achalasia Modified Heller myotomy Dor surgery Partial fundoplication Surgery
CLC: R571
Type: Master's thesis
Year: 2011
Downloads: 15
Quote: 0
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Abstract


Objective: To observe the transabdominal underwent modified Heller myotomy plus Dor surgery for treatment of cardiac achalasia efficacy , designed to be confirmed by follow-up results and statistical data to the surgical treatment of achalasia has the desired effect . Methods : Summary Dor treatment of abdominal underwent modified Heller myotomy joint cardia lost flaccid patients 33 cases , follow-up postoperative effects , respectively gastrointestinal imaging in the preoperative and postoperative January line measurement of esophageal largest diameter , were statistically analysis ; 18 cases of preoperative and postoperative line the esophageal manometry 24hpH monitoring , resting on the preoperative and postoperative esophageal sphincter pressure (LESP) and within 24h reflux longest reflux time ( min ) , lt the pH ; 4.0 time ( min ) pH lt ; 4.0 percentage of time (%) were used for statistical analysis . Results: The short-term effect : after patients still had difficulty swallowing , the remaining 32 cases symptoms improved markedly after 1 month review on gastrointestinal contrast measured esophagus maximum diameter than significantly reduced ( P lt; 0.001 ) , of which 18 The patients postoperative the January review esophageal manometry , and 24hpH monitoring , the measured the LESP value than previously measured values ??decreased significantly ( P lt; 0.001 ) ; 24h reflux episodes , the longest reflux time ( min ) , pH lt ; 4.0 ( 1pH lt ; were decreased 4.0 percentage of time (%) indicators compared with the preoperative , were statistically significant (P lt; 0.05). term efficacy : 30 patients ( 90.9% , 30 / 33 ) patients follow-up , in which the symptoms disappeared in 22 cases (73.3% , 22 / 30 ) to improve eight cases (26.7 %, 8 / 30 ) ; preoperative 24h esophageal pH monitoring confirmed six cases ( 33.3% , 6 / 18 ) there is a difference Conclusion: degree of gastroesophageal reflux , postoperative follow-up there was no ( 0 / 18 ) of reflux esophagitis . serpents modified Heller myotomy plus Dor surgery in addition to achalasia patients can significantly reduce LESP, to reduce the loss of slow outside the upper esophageal continued expansion of the state to improve the symptoms of dysphagia , can effectively prevent postoperative gastroesophageal reflux may be brought , and the surgical procedure is a simpler , less invasive , fewer complications , suitable for clinical promotion .

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CLC: > Medicine, health > Internal Medicine > Digestive and abdominal diseases > Esophageal diseases
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