PWE-165 A single institute experience of surgical treatment for achalasia of cardia institute of minimal access surgery – royal gwent hospital

Abstract

<h3>Introduction</h3> Achalasia of Cardia of is rare motility disorder characterised by inadequate oesophageal peristaltic activity combined with a non-relaxing lower oesophageal sphincter. Non-surgical therapy help to palliate symptoms in the early stages but cardiomytomy achieves a better outcome in advanced achalasia. <h3>Method</h3> A prospective data base of all patients surgically treated for achalasia is electronically maintained including the chief symptomatology, pre-operative investigations, treatment and outcomes. Statistical analysis was conducted using STATA 13.1 software. <h3>Results</h3> 17 patients underwent laparoscopic cardiomyotomy with addition of antireflux procedure in 12 patients. Pre-operative investigations showed sigmoid type morphology on barium swallow in 15 patients and rest were non-sigmoid type. Pearson Chi square test of measure of association between S1 and S2 morphology and symptomatology such as regurgitation, nausea/vomiting, weight loss and haematemesis showed significant association between S1 type morphology and regurgitation, heartburn and weight loss (p = 0.0001). Addition of anti-reflux procedure to cardiomyotomy improved the symptomatic outcome significantly. <h3>Conclusion</h3> Our interim results suggest that the addition of anti-reflux procedure to cardiomyotomy enhance the symptomatic surgical outcome. <h3>Disclosure of interest</h3> None Declared.