Transthoracic Oesophagomyotomy in the Treatment of Achalasia: A 15-year Experience
Oesophageal achalasia was treated with modified Heller's oesophagomyotomy in 51 patients (19 males, 32 females) via thoracotomy in 47 cases and thoracoscopy in 4 cases. A Belsey Mark IV antireflux procedure was added to transthoracic oesophagomyotomy in two cases, because of extended cardiomyot...
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| Veröffentlicht in: | Scandinavian cardiovascular journal : SCJ 1999, Vol.33 (6), p.333-336 |
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| container_title | Scandinavian cardiovascular journal : SCJ |
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| creator | SHAI, S.-E CHEN, C.-Y HSU, C.-P HSIA, J.-Y YANG, S.-S |
| description | Oesophageal achalasia was treated with modified Heller's oesophagomyotomy in 51 patients (19 males, 32 females) via thoracotomy in 47 cases and thoracoscopy in 4 cases. A Belsey Mark IV antireflux procedure was added to transthoracic oesophagomyotomy in two cases, because of extended cardiomyotomy. There were no hospital deaths. The overall improvement rate was 93.5%, with excellent results in 80.6%. Postoperative follow-up averaged 7.4 years. In all four cases of thoracoscopic oesophagomyotomy, simultaneous oesophagoscopy was performed to facilitate the procedure. One patient required repeat surgery 2 months later because of inadequate myotomy. Thirty-one patients, including three with severe gastro-oesophageal reflux, received long-term medication. Barrett's oesophagus developed in two of the 31 patients (6.5%) 4.7 and 7.6 years, respectively, after myotomy and squamous cell carcinoma was diagnosed in a 44-year-old woman 2.2 years postoperatively. The study suggests that transthoracic oesophagomyotomy without antireflux procedure can provide excellent long-term relief of dysphagia in oesophageal achalasia and carries a low risk of serious postoperative complications. |
| doi_str_mv | 10.1080/14017439950141380 |
| format | Article |
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A Belsey Mark IV antireflux procedure was added to transthoracic oesophagomyotomy in two cases, because of extended cardiomyotomy. There were no hospital deaths. The overall improvement rate was 93.5%, with excellent results in 80.6%. Postoperative follow-up averaged 7.4 years. In all four cases of thoracoscopic oesophagomyotomy, simultaneous oesophagoscopy was performed to facilitate the procedure. One patient required repeat surgery 2 months later because of inadequate myotomy. Thirty-one patients, including three with severe gastro-oesophageal reflux, received long-term medication. Barrett's oesophagus developed in two of the 31 patients (6.5%) 4.7 and 7.6 years, respectively, after myotomy and squamous cell carcinoma was diagnosed in a 44-year-old woman 2.2 years postoperatively. The study suggests that transthoracic oesophagomyotomy without antireflux procedure can provide excellent long-term relief of dysphagia in oesophageal achalasia and carries a low risk of serious postoperative complications.</description><identifier>ISSN: 1401-7431</identifier><identifier>EISSN: 1651-2006</identifier><identifier>DOI: 10.1080/14017439950141380</identifier><identifier>PMID: 10622544</identifier><language>eng</language><publisher>Copenhagen: Informa UK Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Esophageal Achalasia - surgery ; Esophagogastric Junction - surgery ; Esophagoscopy ; Esophagus ; Female ; Gastroenterology. Liver. Pancreas. 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A Belsey Mark IV antireflux procedure was added to transthoracic oesophagomyotomy in two cases, because of extended cardiomyotomy. There were no hospital deaths. The overall improvement rate was 93.5%, with excellent results in 80.6%. Postoperative follow-up averaged 7.4 years. In all four cases of thoracoscopic oesophagomyotomy, simultaneous oesophagoscopy was performed to facilitate the procedure. One patient required repeat surgery 2 months later because of inadequate myotomy. Thirty-one patients, including three with severe gastro-oesophageal reflux, received long-term medication. Barrett's oesophagus developed in two of the 31 patients (6.5%) 4.7 and 7.6 years, respectively, after myotomy and squamous cell carcinoma was diagnosed in a 44-year-old woman 2.2 years postoperatively. 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Abdomen</subject><subject>Humans</subject><subject>Male</subject><subject>Malformations</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Postoperative Complications</subject><subject>Retrospective Studies</subject><subject>Surveys and Questionnaires</subject><subject>Thoracoscopy</subject><subject>Thoracotomy - methods</subject><subject>Treatment Outcome</subject><issn>1401-7431</issn><issn>1651-2006</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kN-L1DAQx4Mo3nn6B_gieRDfqjNN07Tqy3KcP-DgQPa9TNOJ7dE2a5Ll3P_eHLuiItxLJjCf7zDzEeIlwluEBt5hBWgq1bYasELVwCNxjrXGogSoH-d_7hcZwDPxLMZbANSNxqfiDKEuS11V5-LbNtAa0-gD2cnKG45-N9J3vxx8yo-cVplGltvAlBZek_RObuxIM8WJ3suNRF0cmIK8-rnjMPFq-bl44miO_OJUL8T209X28ktxffP56-XmurB5o1SoikkRajcM2Bs0tVHOGWwsOmethqFqsKG-NK1hKB07xKEH01juW90adSHeHMfugv-x55i6ZYqW55lW9vvY1a1qy6aCDOIRtMHHGNh1uzAtFA4dQnfvsfvPY868Og3f9wsPfyWO4jLw-gRQtDS7bNFO8Q9XIii4xz4esWl1Pix058M8dIkOsw-_M-qhNT78Ex-Z5jRaCtzd-n1Ys94HjvgFyYCe9g</recordid><startdate>1999</startdate><enddate>1999</enddate><creator>SHAI, S.-E</creator><creator>CHEN, C.-Y</creator><creator>HSU, C.-P</creator><creator>HSIA, J.-Y</creator><creator>YANG, S.-S</creator><general>Informa UK Ltd</general><general>Taylor & Francis</general><general>Scandinavian University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1999</creationdate><title>Transthoracic Oesophagomyotomy in the Treatment of Achalasia: A 15-year Experience</title><author>SHAI, S.-E ; CHEN, C.-Y ; HSU, C.-P ; HSIA, J.-Y ; YANG, S.-S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c431t-34ea3a15fdd1b717673ff718c1ffcc50d4818ab2797e02fef11db078ceb95973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Esophageal Achalasia - surgery</topic><topic>Esophagogastric Junction - surgery</topic><topic>Esophagoscopy</topic><topic>Esophagus</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Male</topic><topic>Malformations</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Postoperative Complications</topic><topic>Retrospective Studies</topic><topic>Surveys and Questionnaires</topic><topic>Thoracoscopy</topic><topic>Thoracotomy - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SHAI, S.-E</creatorcontrib><creatorcontrib>CHEN, C.-Y</creatorcontrib><creatorcontrib>HSU, C.-P</creatorcontrib><creatorcontrib>HSIA, J.-Y</creatorcontrib><creatorcontrib>YANG, S.-S</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Scandinavian cardiovascular journal : SCJ</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SHAI, S.-E</au><au>CHEN, C.-Y</au><au>HSU, C.-P</au><au>HSIA, J.-Y</au><au>YANG, S.-S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transthoracic Oesophagomyotomy in the Treatment of Achalasia: A 15-year Experience</atitle><jtitle>Scandinavian cardiovascular journal : SCJ</jtitle><addtitle>Scand Cardiovasc J</addtitle><date>1999</date><risdate>1999</risdate><volume>33</volume><issue>6</issue><spage>333</spage><epage>336</epage><pages>333-336</pages><issn>1401-7431</issn><eissn>1651-2006</eissn><abstract>Oesophageal achalasia was treated with modified Heller's oesophagomyotomy in 51 patients (19 males, 32 females) via thoracotomy in 47 cases and thoracoscopy in 4 cases. A Belsey Mark IV antireflux procedure was added to transthoracic oesophagomyotomy in two cases, because of extended cardiomyotomy. There were no hospital deaths. The overall improvement rate was 93.5%, with excellent results in 80.6%. Postoperative follow-up averaged 7.4 years. In all four cases of thoracoscopic oesophagomyotomy, simultaneous oesophagoscopy was performed to facilitate the procedure. One patient required repeat surgery 2 months later because of inadequate myotomy. Thirty-one patients, including three with severe gastro-oesophageal reflux, received long-term medication. Barrett's oesophagus developed in two of the 31 patients (6.5%) 4.7 and 7.6 years, respectively, after myotomy and squamous cell carcinoma was diagnosed in a 44-year-old woman 2.2 years postoperatively. 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| ispartof | Scandinavian cardiovascular journal : SCJ, 1999, Vol.33 (6), p.333-336 |
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| source | MEDLINE; Taylor & Francis |
| subjects | Adolescent Adult Aged Biological and medical sciences Esophageal Achalasia - surgery Esophagogastric Junction - surgery Esophagoscopy Esophagus Female Gastroenterology. Liver. Pancreas. Abdomen Humans Male Malformations Medical sciences Middle Aged Postoperative Complications Retrospective Studies Surveys and Questionnaires Thoracoscopy Thoracotomy - methods Treatment Outcome |
| title | Transthoracic Oesophagomyotomy in the Treatment of Achalasia: A 15-year Experience |
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