792. EVALUATION OF EXTENSIVE MYOTOMY ASSOCIATED WITH DOR-MODIFIED ANTERIOR FUNDOPLICATION (PINOTTI) FOR SHORT- AND LONG-TERM TREATMENT OF ACHALASIA: A COHORT STUDY

Abstract

Abstract Introduction Achalasia is the main esophageal motility disorder and has a significant negative impact on the patient's quality of life. The management of achalasia primarily aims to reduce LES pressure. Surgical treatment involves a Heller myotomy, combined with a fundoplication to prevent reflux. Method Prospective cohort study with 79 patients in two hospitals, one public and one private, in the city of Natal, Brazil. To evaluate the effectiveness of the surgical technique developed with the intention of treating achalasia, a long myotomy associated with the modified Dor anterior fundoplication (Pinotti). All patients were evaluated postoperatively as follows: 1) first week after surgery they were interviewed by the master surgeon; 2) thirty days after surgery they were interviewed regarding symptoms of achalasia in the postoperative period. Results Seventy nine (79) patients were submitted for a long myotomy procedure associated with modified Dor anterior fundoplication (Pinotti). Seventy nine (79) patients were followed up. Although, seventy three (73) patients had improvement in symptoms related to achalasia and are clinically satisfied. Six (6) patients had recurrence of achalasia symptoms, such as dysphagia. Conclusion The long myotomy associated with the modified Dor anterior fundoplication (Pinotti) was the standard procedure in the study and obtained good results in 89,83% of the cases followed during the control of achalasia symptoms with a minimum rate of adverse effects in the postoperative period