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PWE-165 A single institute experience of surgical treatment for achalasia of cardia institute of minimal access surgery – royal gwent hospital
  1. M Uppara1,
  2. O Rutka2,
  3. A Rasheed2
  1. 1Upper GI and General Surgery, University Hospital of Wales, Cardiff
  2. 2Upper GI and General Surgery, Royal Gwent Hospital, Newport, UK


Introduction Achalasia of Cardia of is rare motility disorder characterised by inadequate oesophageal peristaltic activity combined with a non-relaxing lower oesophageal sphincter. Non-surgical therapy help to palliate symptoms in the early stages but cardiomytomy achieves a better outcome in advanced achalasia.

Method A prospective data base of all patients surgically treated for achalasia is electronically maintained including the chief symptomatology, pre-operative investigations, treatment and outcomes. Statistical analysis was conducted using STATA 13.1 software.

Results 17 patients underwent laparoscopic cardiomyotomy with addition of antireflux procedure in 12 patients. Pre-operative investigations showed sigmoid type morphology on barium swallow in 15 patients and rest were non-sigmoid type. Pearson Chi square test of measure of association between S1 and S2 morphology and symptomatology such as regurgitation, nausea/vomiting, weight loss and haematemesis showed significant association between S1 type morphology and regurgitation, heartburn and weight loss (p = 0.0001). Addition of anti-reflux procedure to cardiomyotomy improved the symptomatic outcome significantly.

Conclusion Our interim results suggest that the addition of anti-reflux procedure to cardiomyotomy enhance the symptomatic surgical outcome.

Disclosure of interest None Declared.

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