Robotic surgery for the treatment of achalasia.

Autor: Alberich Prats M; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España. Electronic address: malberich94@hotmail.com., Bettonica Larrañaga C; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España., Miró Martín M; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España., Aranda Danso H; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España., Estremiana García F; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España., Farran Teixidor L; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España.
Jazyk: English; Spanish; Castilian
Zdroj: Cirugia espanola [Cir Esp (Engl Ed)] 2021 May 28. Date of Electronic Publication: 2021 May 28.
DOI: 10.1016/j.ciresp.2021.04.013
Abstrakt: Objective: To describe the experience of the robotic approach for achalasia surgery in a tertiary center.
Material and Methods: Patients with achalasia who underwent robotic surgery between May 2010 and April 2019 were analyzed. The study variables were collected in a prospective database and a descriptive analysis was performed.
Results: 45 patients (55.6% male) with a mean age of 44 years were included. The main symptom at diagnosis was dysphagia. 19 patients (42.2%) received endoscopic treatment prior to surgery, mostly pneumatic dilation (84.2%). Heller's myotomy associated with Toupet fundoplication was the surgical technique of choice, with a mean operative time of 211minutes. The average stay was 5 days. There were 2 postoperative perforations (4.4%). Perioperative mortality was 0%. The mean follow-up was 64 months. At 3 and 5 years, a significant decrease in the Eckardt score was observed and the manometric study showed a decrease in the lower esophageal sphincter pressure at rest of 58% and 70%, respectively, with persistence of hypomotility of the esophageal body. Pathological gastroesophageal reflux was diagnosed in two patients (5.4%) and 4 (10.8%) presented recurrence of symptoms, requiring endoscopic pneumatic dilations. In 2 cases, the dilations were not effective, so an endoscopic myotomy was considered.
Conclusions: In our experience, robotic surgery is a safe and effective procedure for the treatment of achalasia.
(Copyright © 2021 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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