World Journal of Surgery ( IF 2.3 ) Pub Date : 2022-05-06 , DOI: 10.1007/s00268-022-06580-3 Rafaella Orlow 1 , Fernando A Herbella 1 , Marco G Patti 2
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Background
Achalasia is a primary esophageal motility disorder characterized by aperistalsis and defective relaxation of the lower esophageal sphincter in response to swallowing. Patients’ symptoms include dysphagia, regurgitation, weight loss, chest pain and aspiration. The disease is idiopathic, and the goal of treatment is to eliminate the resistance determined by the abnormal lower esophageal sphincter, therefore allowing passage of the ingested food from the esophagus into the stomach. Three effective treatment modalities are available today—pneumatic dilatation, peroral endoscopic myotomy, and laparoscopic Heller myotomy with a partial fundoplication.
Methods
We described the technique to perform a laparoscopic Heller myotomy and a Dor fundoplication.
Results
Five steps to perform a laparoscopic Heller myotomy and a Dor fundoplication were described.
Conclusions
The surgical approach is favored in many centers as it is very effective in relieving symptoms, while avoiding pathologic gastroesophageal reflux in most patients.
中文翻译：
腹腔镜 Heller 肌切开术与 Dor 胃底折叠术：经受住时间考验的手术
背景
贲门失弛缓症是一种原发性食管动力障碍，其特征是胃蠕动和下食管括约肌对吞咽的反应有缺陷的松弛。患者的症状包括吞咽困难、反流、体重减轻、胸痛和误吸。这种疾病是特发性的，治疗的目标是消除由异常的下食道括约肌决定的阻力，从而使摄入的食物从食道进入胃部。目前有三种有效的治疗方式——气管扩张术、经口内镜下肌切开术和腹腔镜 Heller 肌切开术和部分胃底折叠术。
方法
我们描述了执行腹腔镜 Heller 肌切开术和 Dor 胃底折叠术的技术。
结果
描述了执行腹腔镜 Heller 肌切开术和 Dor 胃底折叠术的五个步骤。
结论
手术方法在许多中心受到青睐，因为它在缓解症状方面非常有效，同时避免了大多数患者的病理性胃食管反流。
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