Oesophageal achalasia in elderly people: Results of the laparoscopic Heller-Dor myotomy  ( Conference Paper )

Ferulano, G.P.,Dilillo, S.,D'Ambra, M.,Lionetti, R.,Saviano, C.,Fico, D.  

Department of Systematics Patology, Division of Gastrointestinal Rehabilitative Surgery, University of Naples Federico II, Naples, Italy

Abstract

Aims: To assess the outcome of laparoscopic Heller-Dor myotomy for oesophageal achalasia in two groups of patients identified by age (under and over 70 years) using functional and clinical instruments. Background: Current therapies for achalasia can't restore normal motility but can palliate dysphagia. Many other symptoms may persist difficult to quantify and to compare. In order to understand if age is a factor that influences the therapeutic outcome we tested the reliability of a specific QoL instrument for comparing outcomes of surgery for achalasia. Methods: Functional examinations and the Gastrointestinal Quality of Life Index (GIQLI) were used before and after laparoscopic Heller-Dor myotomy. Results: Starting in January 1996, 28 consecutive patients of 32 diagnosed (instrumental evidences) achalasia were operated on laparoscopically for various clinical stages of achalasia. In 78% of patients dysphagia disappeared, the incidence of gastro-oesophageal reflux was of 11%. The patients completed a GIQLI questionnaire preoperatively and after a minimum postoperative follow-up of 1 year. Median preoperative GIQLI score was 78(range 38-109) out of a theoretical maximum score of 144. At a median follow-up of 35 months (range 18-72), the score had significantly improved to 115 (range 71-140). All the items assessing gastrointestinal symptoms and physical, social, and emotional function were significantly improved. There is no difference between the two groups identified. Conclusions: The laparoscopic Heller-Dor myotomy is an effective palliation for acalasia, the medium-term outcome is not affected by the age of the patients. The GIQLI is a reliable instrument to compare the impact of achalasia symptoms on health-related QoL. © Mattioli 1885.

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Author keywords

Elderly people; Laparoscopic Heller-Dor myotomy; Oesophageal achalasia

Indexed Keywords

EMTREE medical terms: aged; anesthesiological techniques; conference paper; elderly care; heart disease; herniorrhaphy; human; inguinal hernia; major clinical study; pathology; postoperative complication; risk factor; statistical significance; surgical risk; surgical technique; tension free technique; treatment outcome; treatment planning

MeSH: Adult; Age Factors; Aged; Aged, 80 and over; Digestive System Surgical Procedures; Esophageal Achalasia; Female; Humans; Laparoscopy; Male; Middle Aged; Muscle, Smooth
Medline is the source for the MeSH terms of this document.