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Main Author:	Alfredo Ruiz-Vega
Format:	Artículo científico
Language:	es
Published:	Academia Mexicana de Cirugía, A.C. 2007
Subjects:	Medicina Acalasia funduplicatura miotomía de Heller
Online Access:	https://www.redalyc.org/articulo.oa?id=66275405
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Miotomía de Heller con funduplicatura laparoscópica (tratamiento endoquirúrgico de la acalasia) Alfredo Ruiz-Vega Ulises Rodríguez-Wong José Luis Hernández-Reguero Javier García-Álvarez Medicina Acalasia funduplicatura miotomía de Heller Objetivo: Presentar la experiencia de cinco años en el tratamientode la acalasia del esófago mediante la miotomía deHeller laparoscópica acompañada de alguna variante de funduplicatura,así como los resultados preliminares de la comparaciónentre los distintos tipos de funduplicatura.Material y métodos: Se estudiaron 14 pacientes con acalasia,en quienes se analizó edad, sexo, sintomatología, hallazgosdel estudio endoscópico, radiológico y manometría en el preoperatorioy posoperatorio, tratamientos previos, tipo de funduplicaturarealizada, tiempos quirúrgicos y evaluación de los resultadosdel tratamiento quirúrgico mediante escala de Visick.Resultados: En los 14 pacientes se realizó miotomía de Heller;el procedimiento antirreflujo fue Dor en ocho, Toupet encuatro y Nissen en dos. El tiempo quirúrgico promedio fue de145 minutos, con disminución del mismo a 130 minutos promedioen quienes se realizó funduplicatura tipo Dor. El tiempo promediode estancia intrahospitalaria fue de 2.5 días y la vía oralse inició a 1.5 días. Los resultados posoperatorios (escala deVisick) fueron: grado I, seis pacientes (42.8 %, Dor cuatro, Toupetuno, Nissen uno); grado II, cuatro pacientes (28.5 %, Dortres, Toupet uno); grado IIIA, dos pacientes (14.2 %, Dor dos);grado IVA, un paciente (7.1 %, Toupet); grado IVB, un paciente(7.1 %, Nissen-Rossetti).Conclusiones: La miotomía de Heller es actualmente el estándarde oro para el tratamiento de la acalasia y se deberáacompañar de procedimiento antirreflujo. Hasta el momentose ha demostrado que la funduplicatura tipo Dor es más segura,rápida y tiene mejores resultados. 2007 artículo científico 0009-7411 https://www.redalyc.org/articulo.oa?id=66275405 es http://www.redalyc.org/revista.oa?id=662 Cirugía y Cirujanos application/pdf Academia Mexicana de Cirugía, A.C. Cirugía y Cirujanos (México) Num.4 Vol.75

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