Laparoscopic myotomy for XXXX : predictors of successful outcome after 200 cases.

@entity1318 @entity1 @entity1282
OBJECTIVE: Laparoscopic myotomy is the preferred treatment of @entity1318 . Our objectives were to assess the long-term outcome of esophageal myotomy and to identify preoperative factors influencing the outcome. METHODS: Preoperative and long-term outcome data were collected from @entity1 undergoing laparoscopic myotomy for @entity1318 at our institution. The primary endpoint of the study was the postoperative change (delta) in @entity1282 score. This score was calculated by combining the frequency and the severity of @entity1282 . Persistent postoperative @entity1282 was defined as 1 standard deviation less than the mean delta score of all @entity1 . Logistic regression was used to identify independent preoperative factors associated with successful myotomy. RESULTS: A total of 200 consecutive @entity1 were included in the study. At a mean follow-up of 42.1 months, the mean delta @entity1282 score was 7.1 +/- 2.6; therefore, the myotomy was considered successful when the delta score was >4.5. According to this definition, 170 (85%) @entity1 achieved excellent @entity1282 relief (responders). Responders had higher preoperative low esophageal sphincter (LES) pressure than nonresponders: 42.6 +/- 13.1 versus 23.8 +/- 7.0 mm Hg (P = 0.001). High preoperative LES pressure remained an independent predictor of excellent response in the multivariate logistic regression model. @entity1 with LES pressure >35 mm Hg had an odds ratio of 21.3, making more likely to achieve excellent @entity1282 relief after myotomy compared with those with LES pressure < or =35 mm Hg (odds ratio, 21.3; 95% confidence interval, 6.1-73.5, P = 0.0001). CONCLUSION: Laparoscopic myotomy can durably relieve symptoms of @entity1282 . Elevated preoperative LES pressure represents the strongest positive outcome predictor.
