Laparoscopic Dor Versus Toupet Fundoplication for the Treatment of Idiopathic Esophageal Achalasia
| Status: | Completed |
|---|---|
| Conditions: | Gastrointestinal |
| Therapuetic Areas: | Gastroenterology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | March 2003 |
| End Date: | August 2011 |
Randomized Prospective Trial of Laparoscopic Heller Myotomy and Partial Fundoplication for the Treatment of Idiopathic Esophageal Achalasia
The primary aim of this study is to test the hypothesis that Heller myotomy and Toupet
fundoplication result in a lower rate of reflux symptoms and positive 24-hour pH testing
when compared to Heller myotomy and Dor fundoplication.
fundoplication result in a lower rate of reflux symptoms and positive 24-hour pH testing
when compared to Heller myotomy and Dor fundoplication.
Idiopathic achalasia is an uncommon motor disorder of the esophagus which occasionally
requires surgical intervention. Although there are several controversial aspects of therapy
for achalasia, laparoscopic myotomy is emerging as the procedure of choice. Several studies
report having good to excellent outcomes following a laparoscopic procedure in approximately
90% of patients. However, a main deterrent to long-term success is the development of
gastroesophageal reflux disease (GERD) despite the use of an antireflux procedure. For this
reason, most surgeons add a partial fundoplication to the myotomy. The gastric fundus can
either be wrapped anterior to the esophagus (Dor fundoplication), or posterior to the
esophagus (Toupet fundoplication). Currently, the type of fundoplication is determined by
surgeon's choice. There exists no systematic comparison of the two procedures. This
multicenter, randomized study aims to evaluate patient outcomes following myotomy and Dor
versus Toupet fundoplication.
requires surgical intervention. Although there are several controversial aspects of therapy
for achalasia, laparoscopic myotomy is emerging as the procedure of choice. Several studies
report having good to excellent outcomes following a laparoscopic procedure in approximately
90% of patients. However, a main deterrent to long-term success is the development of
gastroesophageal reflux disease (GERD) despite the use of an antireflux procedure. For this
reason, most surgeons add a partial fundoplication to the myotomy. The gastric fundus can
either be wrapped anterior to the esophagus (Dor fundoplication), or posterior to the
esophagus (Toupet fundoplication). Currently, the type of fundoplication is determined by
surgeon's choice. There exists no systematic comparison of the two procedures. This
multicenter, randomized study aims to evaluate patient outcomes following myotomy and Dor
versus Toupet fundoplication.
Inclusion Criteria:
- Diagnosis of Achalasia
Exclusion Criteria:
- Prior heller myotomy
We found this trial at
1
site
660 S Euclid Ave
Saint Louis, Missouri 63110
Saint Louis, Missouri 63110
(314) 362-5000
Washington University School of Medicine Washington University Physicians is the clinical practice of the School...
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