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首页> 外文期刊>Surgical Endoscopy >Preoperative lower esophageal sphincter pressure has little influence on the outcome of laparoscopic Heller myotomy for achalasia.
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Preoperative lower esophageal sphincter pressure has little influence on the outcome of laparoscopic Heller myotomy for achalasia.

机译：术前食管下括约肌压力对ach门失弛缓症腹腔镜海勒肌切开术的疗效影响不大。

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BACKGROUND: It is believed that in untreated patients with achalasia, the lower esophageal sphincter (LES) is almost always hypertensive and a Heller myotomy resolves symptoms by decreasing the LES pressure. The incidence of a normal or hypotensive LES in untreated achalasia patients is unknown. The goals of this study were to determine the incidence of a normal or hypotensive LES in untreated achalasia patients and the outcome of laparoscopic Heller myotomy in achalasia patients with either normal or low LES pressure. METHODS: Between January 1990 and May 2002, a diagnosis of achalasia was made in 239 patients. Among 109 patients (46%) who had not previously received any form of treatment, 53 patients underwent laparoscopic Heller myotomy and Dor fundoplication. Based on the preoperative LES pressure (normal, 14-24 mmHg) they were divided into three groups: group A--four patients (7.5%), LES pressure <14 mmHg; group B--18 patients (34%), LES pressure 14-24 mmHg; and group C-31 patients (58.5%), LES pressure >24 mmHg. RESULTS: Among the 109 untreated patients, the LES was hypertensive in 49 patients (45%), normal in 29 patients (27%), and hypotensive in 31 patients (28%). The clinical outcome was good among the three groups of patients who underwent laparoscopic Heller myotomy, with poor outcome in only approximately 10% in each group. CONCLUSIONS: These data show that in 55% of untreated. achalasia patients the LES pressure is either normal or low, and that laparoscopic Heller myotomy usually relieves symptoms regardless of preoperative LES pressure.
机译：背景：据信在未经治疗的门失弛缓患者中，食管下括约肌（LES）几乎总是高血压，而Heller肌切开术可通过降低LES压力来缓解症状。在未经治疗的门失弛缓患者中，正常或低血压LES的发生率尚不清楚。这项研究的目的是确定未经治疗的门失弛缓患者中正常或低血压LES的发生率以及LES压力正常或低的失弛缓患者的腹腔镜Heller肌切开术的结果。方法：在1990年1月至2002年5月之间，对239名患者进行了门失弛症的诊断。在109例（46％）以前未接受任何形式治疗的患者中，有53例接受了腹腔镜Heller肌切开术和Dor胃底折叠术。根据术前LES压力（正常14-24 mmHg）将其分为三组：A组-四名患者（7.5％），LES压力<14 mmHg; B--18组（34％），LES压力14-24 mmHg; C-31组（58.5％），LES压力> 24 mmHg。结果：在109例未经治疗的患者中，LES高血压的有49例（45％），正常的有29例（27％），低血压的31例（28％）。在接受腹腔镜Heller肌切开术的三组患者中，临床结果良好，每组仅约10％的结果较差。结论：这些数据表明，未治疗者占55％。门失弛缓症患者的LES压力正常或较低，无论术前LES压力如何，腹腔镜Heller肌切开术通常都能缓解症状。

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