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首页> 外文期刊>Surgical Endoscopy >The laparoscopic reoperation of failed Heller myotomy.
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The laparoscopic reoperation of failed Heller myotomy.

机译：失败的Heller肌切开术的腹腔镜手术。

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BACKGROUND: Laparoscopic Heller myotomy for achalasia has a 10-20% failure rate and may require reoperation to control persistent, or recurrent symptoms of dysphagia. We report our experience with laparoscopic reoperation for failed Heller myotomy. METHODS: Between 1996 and 2001, 5 patients underwent reoperative laparoscopic Heller myotomy. The mean age was 39 years. The presenting symptoms were persistent dysphagia ( n = 3), recurrent dysphagia ( n = 1), and weight loss ( n = 1). The mean duration between 1st surgery and recurrence of symptoms was 2 months and the mean duration between surgeries was 27.5 months. All operations were completed laparoscopically. RESULTS: There were no intraoperative or postoperative complications. Incomplete gastric myotomy was the cause of all 5 primary surgical failures. The mean hospital stay was 2 days. Mean follow-up was 12.8 months. Results were excellent in 2 patients who reported no dysphagia postoperatively (dysphagia grade 0) and good in 3 patients (60%) who all reported improvement in swallowing (dysphagia grade I-II). CONCLUSION: Laparoscopic reoperation for failed Heller myotomy is feasible with encouraging preliminary results.
机译：背景：腹腔镜H管肌切开术治疗门失弛缓症的失败率为10％至20％，可能需要重新手术以控制吞咽困难的持续性或复发性症状。我们报告了失败的Heller肌切开术的腹腔镜再手术经验。方法：1996年至2001年，有5例患者接受了再次腹腔镜Heller肌切开术。平均年龄为39岁。出现的症状为持续性吞咽困难（n = 3），复发性吞咽困难（n = 1）和体重减轻（n = 1）。第一次手术至症状复发之间的平均时间为2个月，两次手术之间的平均时间为27.5个月。所有手术均在腹腔镜下完成。结果：没有术中或术后并发症。胃肌切开术不完全是所有5例主要手术失败的原因。平均住院时间为2天。平均随访12.8个月。 2例术后无吞咽困难的患者（吞咽困难0级）的结果极好，3例吞咽改善（I-II吞咽困难）的3例患者（60％）的结果良好。结论：腹腔镜手术治疗失败的Heller肌切开术是可行的，并具有令人鼓舞的初步结果。

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