Is post operative contrast swallow necessary following laparoscopic cardiomyotomy for achalasia?

W R Carr, Mr, Y K Viswanath, Mr, Penny Wilson, Dr, Anantha Madhavan, Mr

James cook university hospital

Introduction: Laparoscopic cardiomyotomy for achalasia is an effective treatment for achalasia. Whilst laparoscopic approaches minimize the surgical insult to the patient care needs to be taken to minimize the risk of mucosal perforation. This study aims to identify if intra-operative endoscopy and air leak test followed by post-operative contrast swallows was indicated.

Methods and Procedures: A retrospective audit of Laparoscopic cardiomyotomy performed in a single centre over a 7-year period. A case note review was performed after production of a proforma. 24 cases were identified between 2004-2011.

Results: M:F 5:3, mean age 50(18-79), mean BMI 28(17-37). 9 patients had previously undergone 1 pneumatic dilatation and 4 more than 1 dilatation. Intra-operative endoscopy and air leak test was performed in all cases followed by a post-operative swallow. 1 intra operative mucosal perforation was identified and repaired. No leaks were seen on the post-operative swallow. 1 patient was readmitted with a contained leak 1-week post op.

Conclusions:The addition of a routine post-operative contrast swallow to the intra-operative endoscopy and air-leak test did not change management and failed to predict the only readmission occurring at 1 week post op. The mean length of stay was 2 nights(1-4) and this was determined by the time taken to obtain the contrast swallow.

Session: Poster Presentation

Program Number: P529

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