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Case Reports
. 2018 Jul-Sep;14(3):253-255.
doi: 10.4103/jmas.JMAS_222_17.

Thoracoscopic oesophagectomy for end-stage achalasia

Vaibhav Kumar Varshney  1 , Subhash Chandra Soni  1 , Manju Kumari  1 , Pawan Kumar Garg  2 , Ashok Puranik  1
Affiliations
Case Reports

Thoracoscopic oesophagectomy for end-stage achalasia

Vaibhav Kumar Varshney et al. J Minim Access Surg. 2018 Jul-Sep.

Abstract

Achalasia cardia is an oesophageal motility disorder characterised by aperistalsis and failure of relaxation of the lower oesophageal sphincter. The management is predominantly palliative with focus on addressing the sphincter that involves either pneumatic dilatation or Heller myotomy which relieves dysphagia in the majority of the cases. End-stage achalasia (ESA) is characterised by failed myotomy, massively dilated and tortuous oesophagus with nutritional deterioration due to progressive dysphagia and vomiting. In these subgroups of patients, oesophagectomy may be the last resort. While oesophagectomy has been described for ESA before, thoracoscopic oesophagectomy has not been reported previously. Hereby, we report our experience of performing minimally invasive oesophagectomy (thoracoscopic) with the gastric pull-up.

Keywords: Achalasia cardia; minimally invasive; oesophagectomy; thoracoscopic.

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Conflict of interest statement

There are no conflicts of interest

Figures

Figure 1
Figure 1
(a) Barium swallow and (b) contrast enhanced computed tomography thorax coronal multiplanar reformation image depicting dilated oesophagus with axis deviation and delayed emptying
Figure 2
Figure 2
(a) Thoracoscopic mobilisation of dilated oesophagus; (b) resected specimen of end stage achalasia showing grossly dilated oesophagus throughout its extent
See this image and copyright information in PMC

References

    1. Vaezi MF, Pandolfino JE, Vela MF. ACG clinical guideline: Diagnosis and management of achalasia. Am J Gastroenterol. 2013;108:1238–49. - PubMed
    1. Devaney EJ, Lannettoni MD, Orringer MB, Marshall B. Esophagectomy for achalasia: Patient selection and clinical experience. Ann Thorac Surg. 2001;72:854–8. - PubMed
    1. Banbury MK, Rice TW, Goldblum JR, Clark SB, Baker ME, Richter JE, et al. Esophagectomy with gastric reconstruction for achalasia. J Thorac Cardiovasc Surg. 1999;117:1077–84. - PubMed
    1. Miller DL, Allen MS, Trastek VF, Deschamps C, Pairolero PC. Esophageal resection for recurrent achalasia. Ann Thorac Surg. 1995;60:922–5. - PubMed
    1. Duranceau A, Liberman M, Martin J, Ferraro P. End-stage achalasia. Dis Esophagus. 2012;25:319–30. - PubMed

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