A PROSPECTIVE OBSERVATIONAL STUDY ON MANAGEMENT OF ACHALASIA CARDIA WITH LAPAROSCOPIC HELLERS MYOTOMY AND ITS OUTCOMES USING ECKARDT’S CRITERIA IN A TERTIARY CARE CENTRE IN CENTRAL INDIA
Authors: Dr. Siddhant Shrivastav, Dr. Kartik Sharma*, Dr. Nikita Monteiro, Dr. Umesh Gaikwad, Dr. Vaibhav Pandhare
Publication Date: 2026/10/03
DOI: 10.59551/DOI: 10.59551/IJHMP/25832069/2026.7.2.169
Abstract
<p>Introduction: Achalasia is a primary esophageal motility disease characterized by the absence of peristalsis in esophageal body and abnormal relaxation of the lower esophageal sphincter (LES) in response to swallowing. Surgical approaches for treating achalasia seek to overcome esophageal outflow obstruction by longitudinal division of the anterior muscle fibers of lower esophageal sphincter. This study was conducted to assess the surgical outcomes and post operative complications in post-operative patients of Laparoscopic Hellers Myotomy using Eckdart criteria.</p>
<p>Methods and Materials: A prospective observational study of 23 patients, with achalasia cardia who underwent Laparoscopic Heller’s Myotomy, was performed in Department of General Surgery of Government Medical College and Hospital, Nagpur for a period of 2 years (From August 2020 to August 2022).</p>
<p>Results: In this study of 23 patients, most of the patients were from the age group of >50 years(60.87%) and were female(65.22%). Majority of the patients had the symptoms for >10 years (39.13%) with most patients having a preoperative dysphagia score of 2(69.6%). Most common symptoms were dysphagia(100%), regurgitation(52.17%), chest pain(30.43%) and weight loss(65.22%). Most patients showed dilated esophagus on gastroesophagoscopy(69.57%). Barium esophagogram was done in most of the patients(86.96%). Most patients(82.61% ) showed type II on high resolution Manometry. 56.52% patients underwent fundoplication, only one showed mucosal injury. Most patients were initiated oral sips on Day1(86.96%) and oral feeds on Day 4(56.52%). Most patients(65.2%) had a hospital stay of 5 days. The overall pre-operative Eckardt score was 5.47±2.81. The overall Eckardt score at discharge and at 2 weeks follow up was 1.52±1.20. The overall Eckardt score after 3 and 6 months follow up was 0. All the 23 patients survived the procedure with 0% mortality.</p>
<p>Conclusion: This study demonstrates that laparoscopic hellers Myotomy is both safe and effective. Majority of patients will have symptom improvement with Hellers myotomy, and the majority of them have no recurrence even after very long-term followup.</p>
<p>KEYWORDS: Achalasia, Laparoscopic Hellers Myotomy, Eckardt Score, LES Division, Fundoplication.</p>
References
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