Laparoscopic Heller-Dor myotomy in elderly achalasia patients: a single center experience with PSM analysis.
| Autor: | Palomba G; Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy., Capuano M; Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy., Pegoraro F; Division of Hepato-Biliary-Pancreatic, Minimally Invasive and Robotic Surgery and Kidney Transplantation, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy., Basile R; Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy., Pesce M; Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy., Rurgo S; Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy., Effice E; Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy., Sarnelli G; Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy., De Palma GD; Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy., Aprea G; Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy. |
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| Jazyk: | angličtina |
| Zdroj: | Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy [Minim Invasive Ther Allied Technol] 2024 Feb; Vol. 33 (1), pp. 13-20. Date of Electronic Publication: 2024 Feb 02. |
| DOI: | 10.1080/13645706.2023.2261032 |
| Abstrakt: | Introduction: Achalasia is a rare esophageal motility disorder of unknown etiology. With the ageing of the general population, treatment in elderly patients has become increasingly common; however, the gold standard treatment in this population remains unclear. The aim of this study was to evaluate the outcomes of laparoscopic Heller-Dor myotomy (LHM) in geriatric patients. Material and Methods: In this study, consecutive achalasia patients undergoing LHM at the University Hospital 'Federico II' of Naples from November 2018 to November 2022 were prospectively enrolled. Patients were divided into two groups based on their age at intervention: elderly (≥70 years) and younger (<70 years). The two study groups were compared by minimizing the different distribution of covariates through a propensity score matching analysis (PSM). Results: In both populations, there was a significant improvement in terms of manometric parameters and symptoms after surgery. After applying one-on-one PSM, we obtained a total population of 48 achalasia patients divided into two groups (24 patients each). No significant differences were found in terms of demographic characteristics as well as preoperative and intraoperative variables between two groups. At 12 months from surgery, integrated relaxation pressure (IRP) was significantly lower in patients ≥ 70 years ( p = 0.032), while younger patients scored significantly less at the post-operative Eckardt score ( p = 0.047). Conclusions: Laparoscopic Heller-Dor myotomy is a safe and effective treatment even in elderly patients with rapid post-operative recovery, improvement of symptoms and manometric parameters. |
| Databáze: | MEDLINE |
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