Results of laparoscopic Heller – Toupet surgery for achalasia

Abstract

Background: Currently Heller – Toupet procedure is the main method for achalasia. The aim of this study was to evaluate surgical outcomes of laparoscopic Heller – Toupet surgery for achalasia.

Materials and methodology: This is a retrospective case series conducted at Gastrointestinal Department – Viet Duc Hospital University and Department of General Surgery – Hanoi Medical University Hospital between January 2015 and August 2020, including 71 patients with achalasia who underwent laparoscopic Heller – Toupet surgery. The research contents included clinical and paraclinical features, surgical techniques, perioperative and postoperative complications, and long-term outcomes.

Results: In total, 71 patients with achalasia were underwent laparoscopic Heller – Toupet surgery, male and female rate accounted for 52.1% and 47,9%, respectively. The average age of the cohort was 44,9±13,9. The incidence of symptomatic dysphagia was 100%. Esophageal dilatation grades I, II, III, IV are 7.0%, 76.1%, 15.5% and 1.4%, respectively. The severity of the disease: Stage 0, I, II, III are 2.8%, 57.7%, 33.8% and 5.6%, respectively. The mean of myotomy length was 5.7 ± 1.6 cm. The operative duration was 124.3 ± 27.4 minutes. There was no conversion, as well as intra- and post-operative morbidity. Long-term outcomes: Good (no or very mild dysphagia) was 89.9%, moderate (moderate dysphagia) was 10.1% and clinical incidence of reflux syndrome was 16.7%. There was no case requiring intervention or re-operation.

Conclusions: Laparoscopic Heller – Toupet procedure is safe, low rates of morbidity, and provides good long-term outcomes for achalasia.

Keywords: Achalasia; laparoscopy, Heller – Toupet procedure

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