R. J. Cade FRACS.
MYOTOMY FOR ACHALASIA: TO WRAP OR NOT TO WRAP?*
Article first published online: 8 OCT 2008
© 2008 The Author Journal compilation © 2008 Royal Australasian College of Surgeons
ANZ Journal of Surgery
Volume 78, Issue 10, pages 918–920, October 2008
How to Cite
Cade, R. J. (2008), MYOTOMY FOR ACHALASIA: TO WRAP OR NOT TO WRAP?. ANZ Journal of Surgery, 78: 918–920. doi: 10.1111/j.1445-2197.2008.04692.x
A presentation from this study was delivered at the Australia and New Zealand Gastro-Oesophageal Surgical Association meeting, Melbourne, 2007.
- Issue published online: 8 OCT 2008
- Article first published online: 8 OCT 2008
- Accepted for publication 23 December 2007.
- gastro-oesophageal reflux disease;
One of the potential consequences of carrying out a Heller’s myotomy for achalasia is gastro-oesophageal reflux. Whether it is frequent or severe enough to warrant the routine addition of a fundoplication to the operation is debated. In this prospective series of all patients undergoing a myotomy using a minimally invasive method the incidence of gastro-oesophageal reflux disease is examined. It was found that in 124 patients who had been followed for at least 6 months, whereas mild heartburn was common (51 patients; 41%), in only 10 patients (8.2%) was a proton pump inhibitor required and there were no patients whose reflux was not controlled using standard medical treatment. Peptic oesophagitis was an infrequent endoscopic finding with only 3 of 40 patients with no or mild heartburn having mild oesophagitis and no patient on a proton pump inhibitor having active peptic oesophagitis. These findings suggest that the addition of a fundoplication to a Heller’s myotomy to prevent gastro-oesophageal reflux disease is not essential.