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CHEST PAIN BEFORE AND AFTER LAPAROSCOPIC CARDIOMYOTOMY FOR ACHALASIA
Author(s) -
Wullur C.,
Watson D. I.,
Bessell J. R.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04920_18.x
Subject(s) - medicine , dysphagia , odynophagia , achalasia , chest pain , surgery , myotomy , laparoscopic surgery , regurgitation (circulation) , general surgery , laparoscopy , esophagus
Purpose: Laparoscopic cardiomyotomy with anterior partial fundoplication usually achieves good outcomes for patients with achalasia. However, some patients continue to experience chest pain after surgery, even when symptoms such as dysphagia have resolved. Previous studies have not investigated this. Hence, in this study we sought to identify the outcome of chest pain following laparoscopic myotomy. Methodology: The outcome of chest pain in 157 patients who underwent laparoscopic cardiomyotomy and anterior partial fundoplication was determined. Patients underwent symptom assessment before and after surgery using a standardised questionnaire. This determines evaluated chest pain, and other symptoms including odynophagia, dysphagia and regurgitation, and overall satisfaction with the outcome. Results: Chest pain levels were similar across all age groups and sexes before and after surgery. Following surgery, there was a significant reduction in the frequency of chest pain (daily chest pain declined from 27% to 6%). 60% still experienced some degree of chest pain after surgery. Of these, 72% also reported dysphagia, 14% odynophagia, and 35% acid regurgitation (66%, 12% and 23% before surgery). Conclusion: Chest pain is common before and after cardiomyotomy for achalasia, and it is frequently associated with dysphagia. Whilst it occurs less frequently after surgery, it will persist in many patients, and this information should be provided to individuals with achalasia who are being considered for surgical treatment.