Clinical Effect of laparoscopic Heller Sphincterotomy Combined with Dor Fundoplication in Treatment of Cardiocha-lasia

JI Tao; WU Ji-min; HU Zhi-wei; WANG Zhong-gao

doi:10.3969/j.issn.1002-3429.2017.12.025

Abstract：Objective To investigate clinical effect and safety of laparoscopic Heller sphincterotomy combined with Dor fundoplication in treatment of cardiochalasia. Methods A total of 198 cardiochalasia patients undergoing laparoscopic Heller sphincterotomy combined with Dor fundoplication during January 2009 and December 2015 were recruited in this study. Dysphagia symptoms score, score of life quality and body weight were evaluated on 1 d before operation and in 1 month after operation, and changes of high-resolution pressure measurement, upper digestive tract angiography and gastroscope examina-tion were also observed, and incidence rate of postoperative complications were recorded. Results The surgeries were suc-cessful for all patients, and 31 patients were lost follow-up, and 167 patients were followed up for 6-84 ( 65. 3 ± 10. 6 ) months, and there were no obvious complications during and after surgeries. After surgeries, dysphagia was obviously re-lieved, and there were 12 patients with reflux and heartburn, 6 patients with slowly hypopharyngeal food, 5 patients with ab-dominal distension and 3 patients with little relief. With postoperative 6-9 months review for 42 patients, oesophageal high-res-olution pressure measurement showed no elevated lower esophageal sphincter ( LES) basic pressure, and resting pressure of e-sophageal body was lower than that of gastric pressure;gastroscopy showed that there was no resistance when mirror was ente-ring the LES;Upper gastroenterography showed that there was no peristaltic wave, and postoperative extension degrees in 18 patients were decreased compared with those before surgeries. There were significantly differences in dysphagia score, life quality score and body weight before and after surgeries (P<0. 05). Conclusion Laparoscopic Heller sphincterotomy com-bined with Dor fundoplication in treatment of cardiochalasia is safe with few complications, and it can improve dysphagia symptom and improve quality of life.