Patient Satisfaction Best Determines the Management of Recurrent Dysphagia After Heller Myotomy for Achalasia

Heller myotomy (HM) is an effective treatment for achalasia, however failure to reliably achieve long-term palliation of dysphagia occurs in about 10%. It is unclear when and how best to manage these patients. We sought to characterize patients with recurrent dysphagia with particular focus on the management of this difficult patient population. METHODS: A prospectively entered database of all achalasia patients undergoing HM at a single institution (1997-2007) was reviewed for recurrent dysphagia: variables included demographics, health-related physical (P) and mental (M) quality of life (QoL) (SF12), dysphagia and satisfaction (SAT) scores (0 best – 5 worse), Ba upper GI, motility studies (EMS) and endoscopy (EGD). Recurrent dysphagia was defined as initial reduction of >=2 in the dysphagia score followed by increase in the score of >=2 at any time period. We analyzed the clinical course, investigations, and treatment of recurrent dysphagia patients in relation to QoL and satisfaction scores. Data presented as median (range); paired t-test or Wilcoxon signed ranks test determined significance (*p

Session: Poster of Distinction

Program Number: P009

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