Long-Term. WAS: Summary of my heller myotomy with dor fundoplication - hope this helps

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Preeti wrote:

>

> ... (I was under the presumption that it is good for maximum 20 years

> and then another surgery or dilation is need). Of course need to

> remember Cara's advise to keep up with the follow up tests.

>

Another thing that probably helps a lot in getting the most years out of

a myotomy is not to take acid reflux for granted. It often does not

start out being a problem and comes on gradually over years. In that

time things can change so slowly that a person just tries to adjust to

it. A number of studies have report that they believe the main reason

myotomies fail or people need an esophagectomy is because of problems

that likely are caused by untreated or inadequately treated acid reflux.

Another thing I suggest is that people not ignore changes in their

symptoms. Changes may indicate things that you need your doctor to check

so that things don't get worse.

>

> Also, it seems like big % of people get success with the surgery and

> go on in life without any further surgery or dilation and may not

> require esophagectomy.

>

There are so many more myotomies done for achalasia each year compared

to the number of esophagectomies done for achalasia that to me this says

that most people don't live long enough to need an esophagectomy, yet

statistics say we live as long as others and very few die from achalasia

related problems, including esophageal cancer and aspiration pneumonia.

This says to me that the risk of needing an esophagectomy is relatively

small.

> I was so sacred as it sounded like from reading posts that most people

> needed 2nd surgery or dilation's and eventually ended up with

> esophagectomy.

>

One has to understand and come to terms with the fact that we may need

these things but there are no guarantee that you will need them.

Needing a dilatation would be the most common. The good news about that

is it is usually just an out patient procedure without complication and

you are back to work the next day.

> Does age of the patient play any role in all this research?

>

Children with achalasia are so rare that it is hard to have enough of

them to do any meaningful long-term study. Long-term studies are hard to

do anyway and for achalasia 10 to 20 years has been about as long as any

studies have fallowed patients. So many patient with achalasia are

elderly when diagnosed that some die and are lost from long-term studies

before the studies are finished. That all makes it hard to tell just how

time effects a myotomy but the number of myotomy done in a year compared

to the number of esophagectomies must mean something in spite of these

problems with studies.

notan