Quality of life before and after laparoscopic Heller myotomy for achalasia

Background: Because the surgical treatment of achalasia is directed at the palliation of chronic symptoms, it is important to assess how surgery affec ts patients' health-related quality of life (HRQL). Methods: We evaluated upper gastrointestinal symptoms, satisfaction, and HR QL in 19 patients with achalasia before and after undergoing a laparoscopic Heller myotomy and partial fundoplication. HRQL was assessed using the Med ical Outcomes Study 36-item short form health survey (SF-36). Results: The mean age of the patients was 40 years (range 16 to 74), and 58 % were men. After a median follow-up of 21 months (range 2 to 35), 12 of 16 patients were satisfied with the results of their surgery. Liquid and soli d dysphagia scores were improved after surgery, and the prevalence of heart burn symptoms did not change. Although all the health concepts measured by the SF-36 instrument showed some improvement, statistically significant inc reases (on a 0 to 100 scale) were detected in physical functioning (11.1, P = 0.02), role-physical (25.0, P = 0.05), bodily pain (12.2, P = 0.01), vit ality (13.7, P = 0.02), and social functioning (18.4, P = 0.02). Conclusions: Most aspects of HRQL improve after a laparoscopic Heller myoto my and partial fundoplication for achalasia. (C) 2001 Excerpta Medica, Inc. All rights reserved.