Surgery Outcomes and Quality of Life in Achalasia's Treatment

Abstract

Objectives:

Evaluate the quality of life (QoL) in patients diagnosed with achalasia who performed Heller's myotomy.

Methods:

Between January 1, 2000 and March 27, 2019, 99 patients were submitted to esophagomyotomy at the São João Hospital in Oporto, Portugal. The exclusion criteria were other diagnoses, age <18 years at the date of surgery, and death. Seventy-five patients were contacted. Pre- and postoperative evaluations were performed using the achalasia disease-specific QoL questionnaire and by the Eckardt score. QoL was assessed by the Medical Outcomes Study SF-36.

Results:

Forty-nine patients (65%) answered the questionnaires. The median difference in the achalasia-DSQoL questionnaire between the pre- and postoperative period was −9.0 (interquartile range [IQR]: 5–12), whereas in the Eckardt score was −5.0 (IQR: 3.25–7). Lower postoperative scores correlated with higher scores on the SF-36's mental and physical summary measures (Spearman's rho [ρ] = −0.651 and ρ = −0.577 for the achalasia-DSQoL questionnaire and ρ = −0.552 and ρ = −0.515 for the Eckardt score, P < .001). Physical and mental summary measures were correlated with each other (ρ = 0.788, P < .001).

Conclusions:

Heller's myotomy allows a decrease in symptoms and an increase in QoL. Patients with severe symptoms before surgery had higher postoperative scores and patients with fewer symptoms had lower postoperative scores.