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. 2016 Feb;98(2):150-4.
doi: 10.1308/rcsann.2016.0063.

Day surgery for achalasia cardia: Time for consensus?

D N Naumann  1 , S Zaman  1 , M Daskalakis  1 , R Nijjar  1 , M Richardson  1 , P Super  1 , R Singhal  1
Affiliations

Day surgery for achalasia cardia: Time for consensus?

D N Naumann et al. Ann R Coll Surg Engl. 2016 Feb.

Abstract

Introduction: Laparoscopic Heller's myotomy (LHM) is the most effective therapy for achalasia of the oesophagus. Most case series of LHM report a length of hospital stay (LOS) >1 day. We present 14 years of experience of LHM to examine the safety and feasibility of LHM as a day case procedure.

Methods: We retrospectively examined patients undergoing elective LHM for achalasia at our institution between 2000 and 2014. Demographics, episode statistics, prior investigations and interventions were collated. Outcomes, including LOS, complications and re-interventions, were compared for the periods before and after a consensus decision at our institution in 2008 to perform LHM as a day case procedure.

Results: Sixty patients with a mean age of 41 ± 13 years were included, of whom 58% were male. The median LOS for all patients was 1 day (interquartile range [IQR] 0-2.25). Overall, LHM was performed as a day case in 27 (45%) cases, at 2/26 (7.7%) in the first period versus 25/34 (73.5%) in the second (p<0.01). There were no significant differences in age, gender or previous interventions between day surgery and non-day surgery groups. One patient required subsequent unplanned surgery, while six (10%) needed endoscopic treatment of recurrent symptoms within 12 months.

Conclusions: LHM can be performed safely as a day case procedure. Complication rates are low, with only a small proportion of patients requiring endoscopic treatment for symptom recurrence within 1 year.

Keywords: Achalasias; Ambulatory Surgery; Esophageal; Laparoscopy; Surgery, day.

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Figures

Figure 1
Figure 1
Length of hospital stay following laparoscopic Heller’s myotomy for achalasia by time period
See this image and copyright information in PMC

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