Laparoscopic oesophagocardiomyotomy :our experience
Chowbey, P.K.; Dhir, A.; Khullar, R.; Sharma, A.; Soni, V.; Baijal, M.; Vashishtha, A and Dewan, A. (2002) Laparoscopic oesophagocardiomyotomy :our experience. In: 5th Annual Conference of Indian Association of Gastrointestinal Endo-surgeons (IAGES), 31st Jan - 3rd Feb 2002, Kolkatta, India.
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Achalasia Cardia is a rare functional oesophageal disorder which is characterized by impairment of relaxation at the lower oesophageal sphincter in response to normal oesophageal peristaltic activity. The pathologic finding is an absence, decrease or degeneration of ganglion cells in the myenteric plexus of the lower oesophageal sphincter. The condition being essentially irreversible the treatment is directed at achieving symptomatic relief. The treatment may be medical i.e. Pneumatic dilatation, or surgical which up to now was open oesophagocardiomyotomy. Medical treatment was preferred up to now, being associated with minimal morbidity and a reasonably good symptomatic relief, making it highly acceptable for the patient. We present Laparoscopic Oesophagocardiomyotomy which should be considered the treatment of choice as it gives excellent results comparable to the open procedure minus all the incision related morbidity associated with the latter. A total of nine (9) patients have been treated by this method. One (1) patient had intra-operative mucosal perforation which was closed by intracorporeal suturing. A gastro graffin swallon was done on day one after surgery in three (3) patients and on day two in two (2} patients. Patients were discharged two days after the surgery. All patients have been asymptomatic on a follow-up of two years to six months.
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