Surgical treatment of achalasia: Transabdominal versus transthoracic cardiomyotomy

Bagheri, R. and Haghi, S. Z. and Noorshafiee, S. (2011) Surgical treatment of achalasia: Transabdominal versus transthoracic cardiomyotomy. Annals of Thoracic and Cardiovascular Surgery, 17 (3). pp. 254-259.

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Abstract

Background: Achalasia is a primary esophageal motor disorder involving the body of theesophagus and lower esophageal sphincter. The mechanism is destruction of the myentericplexus after a viral infection. Multiple methods of treatment with variable results induced in achalasia. Materials and Methods: We analyzed 70 patients with achalasia that underwent surgical treatment with trans abdominal or transthoracic cardiomyotomy from 1982 to 2008 in Mashhad (Ghaem and Omid) hospital and at least 2 years follow up for evaluated result ofsurgery. Results: The mean age was 39.2 ± 9.42 years and the M/F = 0.89. The most common symptom was dysphagia (100). The interval between beginnings of symptoms to a definitivediagnosis was 10.6 ± 8.3 month. The ratio between the two techniques was 35/35 = 1. In67.1 of patients, a previous history of pneumatic dilation was reported. Long-term goodresults after surgery were seen in 77.2 of patients. Recurrence after surgical treatment wasseen in 22.8. A comparison of the two techniques (with or without antireflux surgery),showed a greater failure rate in trans abdominal cardio myotomy without the anti reflux protocol(8/15 = 40), but by the chi- square test, the difference was not statistically significant(P = 0.107). The most common complication after surgery was esophageal leakage (2.85),and mortality was zero. In recurrence, most patients underwent pneumatic dilation (9/16 =56.2), and if surgery was needed, all patients underwent a transthoracic approach with antireflux treatment. Conclusion: Based on the good, long-term results with the surgical treatment of achalasia, surgery is recommended in most patients. A transthoracic or transabdominal approach had good, long-term results, but a transthoracic approach had better results and usually did notneed antire flux surgery. © 2011 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery. All rights reserved.

Item Type: Article
Additional Information: Cited By :1 Export Date: 16 February 2020 Correspondence Address: Bagheri, R.; Thoracic Surgery, Mashhad University of Medical Sciences, Ahmad Abad Street, Mashhad, Iran; email: Bagherir@mums.ac.ir
Uncontrolled Keywords: Achalasia- cardiomyotomy Transabdominal Transthoracic abdomen abdominal surgery adolescent adult article cardia chi square distribution comparative study dysphagia esophagus achalasia female human Iran male middle aged radiography recurrent disease risk assessment risk factor thoracotomy time treatment outcome Chi-Square Distribution Deglutition Disorders Digestive System Surgical Procedures Esophageal Achalasia Humans Recurrence Risk Factors Time Factors Young Adult
Subjects: WI Digestive System
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib7 lib7
Date Deposited: 03 May 2020 06:55
Last Modified: 03 May 2020 06:55
URI: http://eprints.mums.ac.ir/id/eprint/16933

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