Study Of Treating Achalasia By Transabdominally Performing Augmented Heller With Dor Added

Objective:To observe the effect of the operation of transabdominally performing augmented Heller with Dor added to treat achalasia, and to establish through follow-up and statistical data that this operation could reach good effects to patients with achalasia.Method:To summarize 33 cases of achalasia treated ransabdominally performing augmented Heller with Dor added and visit them postoperatively, and all of them were accepted upper gastroenterography to measure the maxim esophagus diameter (MED)both preoperatively and postoperatively and then compare them in statistical mothods; 18 of them accepted the measurement of LES pressure(LESP) and 24-hour-pH monitoring such as the reflux frequency,the longest lasting-time of reflux,the total time(min) of pH<4.0 and the percentage(%) of time of pH<4.0 both preoperatively and postoperatively, and then compare them in statistical mothods.Results:As for a short effect,1 patient had the same dysphasia as preoperative and all of the rest modified. Then reexamine upper gastroenterography,the measurement of LESP measurement and 24-hour-pH monitoring one month after each operation. And the radiation showed obvious decrease of the maxim esophagus diameters than preoperation (P<0.001); the latter two examinations analyzed the data:the LESP came down compared with preoperative(P<0.001); the reflux frequency,the longest lasting-time of reflux,the total time(min) of pH<4.0 and the percentage(%) of time of pH<4.0 also declined after operations (P<0.05). For a long run follow,30 patients was visited,22(73.3%,22/30) of which were cured and 8 of which modified effectively. Preoperatively,6 cases(33.3%,6/18) were established reflux, and none(0/18)of them were detected reflux in the follows. Conclusions:Transabdominally performing augmented Heller with Dor added could dramadically decline the LESP, diminish the continued dilation of esophagus above the achalasia part, and alleviate the symptoms of patients with achalasia; moreover, it could especially prevent the postoperation-reflux, and with the advantages of simple opertions, little traumas and so on, which could be popularized clinically.