Body Mass Index Does Not Affect the Surgical Outcome of Laparoscopic Heller-Dor Surgery for Achalasia Patients

Kazuto Tsuboi, MD, Nobuo Omura, MD, Fumiaki Yano, MD, Masato Hoshino, MD, Se Ryung Yamamoto, MD, Shunsuke Akimoto, MD, Hideyuki Kashiwagi, MD, Katsuhiko Yanaga, MD. Department of Surgery, Jikei University School of Medicine, Tokyo, JAPAN


Back ground: Laparoscopic Heller-Dor surgery (LHD) is widely performed as the gold standard treatment for patients with achalasia. The most patients with achalasia suffer from body weight loss since dysphagia, the chief compliant of this disease is associated with disturbed oral intake. According by, the analyses of surgical outcome for LHD in view of body mass index are rare. The aim of this study is to clarify the effect of body weight on the surgical outcome of LHD.

Material and Method: Between August 1994 and February 2011, 291 patients who underwent LHD in our institution. Of these, 7 redo patients and 53 patients whose follow up periods are less than one year were excluded, and the remaining 231 patients (age 43.8±14.7 years, 107 women) were studied. Patients were divided into three groups by body mass index (BMI); group A, BMI< 20 (n= 112); group B, BMI= 20-25 (n= 106), group C; BMI? 25 (n= 13). Surgical results, patients’ post-operative symptom scores, patients’ satisfaction, and post-operative course were compared.

Results: The average age was 43.8±14.7 and mean BMI was 20.3±3.1 in our patients. Average BMI was18.0±1.5 in group A, 21.8±1.3 in group B,and 28.2±4.0 in group C. Group A was significantly younger (p=0.026) and had significantly greater proportion of female gender than the other two groups (p=0.002). There were no differences in operation time, blood loss, and the rate of mucosal injury between the three groups. Also, the post-operative symptom score and the satisfaction score were comparable. In addition, the occurrence of reflux esophagitis after surgery was not significantly different between the three groups.

Conclusion: The surgical outcome of LHD and post-operative symptoms in patients with achalasia were not affected by body mass index (BMI).

Session Number: Poster – Poster Presentations
Program Number: P182
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