Results of short- and long-segment cardioesophageal myotomy for achalasia
- PMID: 22824765
- PMCID: PMC3409883
- DOI: 10.4103/1319-3767.98426
Results of short- and long-segment cardioesophageal myotomy for achalasia
Abstract
Background/aim: We report the results of a short- and long-segment cardiomyotomy for relief of the symptoms of achalasia.
Patients and methods: From 1997 to 2009, 41 patients (22 men, 19 women) with achalasia underwent cardiomyotomy. Patients were divided into 2 groups [short-segment group (SSG) and long-segment group (LSG)]. SSG include 22 patients with laparotomy and 8-cm short-segment myotomy and Dor fundoplication. LSG includes 19 patients with thoracotomy and 12-cm long-segment myotomy and Belsey partial fundoplication. results: Median follow up was 48 months (range: 12-70 months). Postoperative dysphagia improved in 20 patients in SSG and in 17 patients in LSG (P < 0.001). Slow emptying sensation improved in 19 patients in SSG and in 16 patients in LSG postoperatively (P < 0.001). Heartburn was present in 2 patients in SSG and 3 patients in LSG postoperatively (P = 0.179). Radiologically, barium stasis decreased significantly from 88% to 25% in SSG and from 85% to 30% in LSG. The lower esophageal sphincter (LES) gradient decreased from 32 to 10 mmHg in SSG and from 34 to 14 mmHg in LSG (P < 0.001).
Conclusions: Short-segment cardiomyotomy reduces the LES gradient and relieves obstructive symptoms.
Conflict of interest statement
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References
-
- Kesler KA, Tarvin SE, Brooks JA, Rieger KM, Lehman GA, Brown JW. Thoracoscopy-assisted Heller myotomy for the treatment of achalasia: results of a minimally invasive technique. Ann Thorac Surg. 2004;77:385–92. discussion 391-2. - PubMed
-
- Almarhabi Y, D’Journo XB, Chen LQ, Martin J, Ferraro P, Duranceau A. A short 4-cm oesophageal myotomy relieves the obstructive symptoms of achalasia. Eur J Cardiothorac Surg. 2009;36:894–900. - PubMed
-
- Csendes A, Braghetto I, Burdiles P, Csendes P. Comparison of forceful dilatation and esophagomyotomy in patients with achalasia of the esophagus. Hepatogastroenterology. 1991;38:502–5. - PubMed
-
- Topart P, Deschamps C, Taillefer R, Duranceau A. Long-term effect of total fundoplication on the myotomized esophagus. Ann Thorac Surg. 1992;54:1046–51. discussion 1051-2. - PubMed
-
- Chen LQ, Chughtai T, Sideris L, Nastos D, Taillefer R, Ferraro P, et al. Long-term effects of myotomy and partial fundoplication for esophageal achalasia. Dis Esophagus. 2002;15:171–9. - PubMed
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