Improving Digestive and Nutritional Status of Patients with Achalasia after Laparoscopic Heller Myotomy Surgery

Amini, Masoud; Karimi, Alireza; Keshtkar, Alireza; Rezaei, Behzad; Abdollahi, Farshad; Haghighat, Neda; Moeinvaziri, Nader

doi:10.30476/ijns.2025.105299.1389

Improving Digestive and Nutritional Status of Patients with Achalasia after Laparoscopic Heller Myotomy Surgery

Document Type : Original Article

Authors

Masoud Amini ¹

Alireza Karimi ²

Alireza Keshtkar ³

Behzad Rezaei ⁴

Farshad Abdollahi ¹

Neda Haghighat ¹

Nader Moeinvaziri ¹

¹ Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

² Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

³ Research Center for Noncommunicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran

⁴ Department of surgery, Lar university of medical sciences, Fars province, Iran

10.30476/ijns.2025.105299.1389

Abstract

Background: Nowadays laparoscopic Heller Myotomy (LHM) with partial fundoplication is recommended as the first line of therapy for esophageal achalasia. This study aimed to determine the early efficacy of LHM as the achalasia treatment.
Methods: A retrospective study was performed on patients diagnosed with achalasia from 2012 to 2019. Each patient underwent LHM with fundoplication. The clinical success of the surgery was defined as the Eckardt score<3. Symptoms such as dysphagia, regurgitation, retrosternal pain, regurgitation, and weight loss have been measured pre- and postoperation.
Results: A total of 28 patients entered the study including 40% women (11) and 60% men (17). Ten patients underwent LHM following Toupet and 18 patients underwent Dor as a fundoplication. Participants were followed by the Eckardt symptom scoring system. Totally, 89.2% of patients demonstrated improvement after LHM.
Conclusion: LHM with fundoplication was shown to be an effective surgical method to improve achalasia symptoms regardless of the type of fundoplication as about 90% of the patients who underwent LHM illustrated fewer symptoms.

Highlights

Masoud Amini (Google Scholar)

Nader Moeinvaziri (Google Scholar)

Keywords

Nutrition

Digestion

Esophageal achalasia

Laparoscopy

Heller Myotomy