Clinical outcomes and quality of life in patients undergoing laparoscopic Heller myotomy combined with fundoplication for achalasia

Background and objectives. This study aimed to evaluate the clinical outcomes and health-related quality of life (HRQoL) in patients undergoing laparoscopic Heller myotomy combined with fundoplication for achalasia in a Vietnamese population. Materials and methods. A descriptive cohort study was conducted on 39 patients with confirmed achalasia who underwent laparoscopic Heller myotomy with Dor fundoplication at Nghe An General Friendship Hospital. Clinical outcomes were assessed using symptom resolution, Eckardt scores, weight changes, esophagography, and endoscopy. HRQoL was measured using the SF-36 questionnaire before and six months after surgery. Statistical analysis was performed using paired t-tests for continuous variables. Results. The mean follow-up duration was 27.21 ± 13.50 months. Clinical recurrence occurred in only two patients (5.1%). Eckardt scores significantly decreased from 7.36 ± 1.61 preoperatively to 0.36 ± 0.93 at the study endpoint (p < 0.05). Postoperative weight gain occurred in over 80% of patients, with a mean increase of 5.94 kg. Endoscopic and radiological findings improved markedly. SF-36 scores improved significantly across all eight domains, particularly in bodily pain, role emotional, and general health (p < 0.001). The overall QOL score increased from 73.64 ± 10.51 to 85.93 ± 7.32 postoperatively. Conclusions. Laparoscopic Heller myotomy combined with fundoplication is an effective and durable surgical treatment for achalasia. It significantly reduces symptoms, improves esophageal function, enhances nutritional status, and leads to substantial improvements in patients’ quality of life.