Laparoscopic Heller’s cardiomyotomy for achalasia cardia-a case series with review of literature

Abstract

Laparoscopic Heller’s cardio myotomy has almost completely replaced the open procedure performed for achalasia cardia. Several studies have suggested that long-term results with surgery for achalasia cardia are better than a medical line of management. In this retrospective study, we outline our experience with laparoscopic cardio myotomy over 15 years. Also, we compare our results with those of other interventional modalities which are known therapeutic options for achalasia cardia. We identified 10 patients (4 females and 6 males) operated upon by a single surgeon from 2008 to 2023, at our institution. The age range was 16-48 years. All patients had undergone oesophago-gastro-duodenoscopy (OGD scopy), upper gastro-intestinal (UGI) manometry and contrast enhanced computerised tomography (CECT) of the lower chest and upper abdomen. The patients were analysed for age, sex, symptoms, pre-operative evaluation, the exact procedure performed (Heller’s+Toupet’s vs Heller’s+Dorr’s), morbidity/mortality and functional outcomes. They were also reviewed to examine the length of stay, length of procedure, complications and recurrent symptoms on follow-up.