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Day surgery for achalasia cardia: Time for consensus?

Naumann, D N and Zaman, S and Daskalakis, M and Nijjar, R and Richardson, Martin and Super, Paul and Singhal, Rishi (2016) Day surgery for achalasia cardia: Time for consensus? Annals of the Royal College of Surgeons of England, 98 (2). pp. 150-4. ISSN 1478-7083. This article is available to all HEFT staff and students via ASK HEFT Discovery tool http://tinyurl.com/z795c8c using their HEFT Athens Login.

Full text not available from this repository.
Official URL: http://publishing.rcseng.ac.uk/doi/abs/10.1308/rcs...

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.

Item Type: Article
Additional Information: This article is available to all HEFT staff and students via ASK HEFT Discovery tool http://tinyurl.com/z795c8c using their HEFT Athens Login.
Subjects: WO Surgery
Divisions: Planned IP Care > General Surgery
Related URLs:
Depositing User: Miss Adele Creak
Date Deposited: 31 Jan 2017 14:06
Last Modified: 31 Jan 2017 14:06
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1135

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