Heller cardiomyotomy with or without intra operative upper endoscopy in the management of cardiac achalasia: a prospective randomized study | ||
| The Egyptian Journal of Surgery | ||
| Volume 44, Issue 4, October 2025, Pages 1265-1272 PDF (458.31 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2025.363309.1406 | ||
| Authors | ||
| Mohamed Abdel Hamid Abdel Aziz* 1; Ashraf Kamal Abdallah2; Mohamed Ibrahim Hasan2; Mohammed Abdalmegeed Hamed2 | ||
| 1Department of General Surgery, Faculty of Medicine, Alexandria University, Egypt. | ||
| 2Department of General Surgery, Faculty of Medicine, Ain Shams University, Egypt. | ||
| Abstract | ||
| Background: Esophageal achalasia is an inflammatory illness characterized by esophageal aperistalsis and lower esophageal sphincter failure. Aim: To compare laparoscopic Heller’s cardiomyotomy with or without intraoperative endoscopy in managing achalasia, focusing on the impact of endoscopy on myotomy adequacy, benefits, and complications. Materials and methods: This prospective randomized investigation has been conducted at Ain-Shams University Hospitals and involved twenty cases. A total of ten cases underwent Heller's cardiomyotomy with Dor fundoplication, while an additional ten cases underwent the same procedure with intraoperative endoscopic guidance. Results: In every instance, preoperative, intraoperative, and postoperative data were evaluated methodically. Twenty patients (100%) had dysphagia, seventeen (85%) had regurgitation, fifteen (75%), and ten (50%) had chest discomfort following meals as preoperative symptoms. Thirteen patients (65%) lost weight. Eight patients (40%) declined balloon dilations, one patient (5%) tried botulinum toxins, and twelve patients (60%) underwent two to three pneumatic dilations. Preoperative. Conclusion: In addition to serving as a guide to ensure an appropriate myotomy, Heller's cardiomyotomy with endoscopic guidance is crucial for limiting the extent of the myotomy and so minimizing reflux symptoms after surgery. | ||
| Keywords | ||
| Achalasia; dysphagia; endoscopy; fundoplication; heller’s myotomy | ||
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