Cardioplasty and Roux-en-Y partial gastrectomy (Serra-Dória procedure) for reoperation of achalasia
Main Author: | |
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Publication Date: | 2004 |
Other Authors: | , , , |
Format: | Article |
Language: | eng |
Source: | Arquivos de gastroenterologia (Online) |
Download full: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032004000300004 |
Summary: | BACKGROUND: After cardiomyotomy for the treatment of megaesophagus, recurrence of symptoms occur in up to 15% of the patients, but only some require a reoperation. AIM: To evaluate the results of reoperation - cardioplasty with Roux-en-Y partial gastrectomy, a technique proposed by Serra-Dória. CASUISTIC AND METHODS: Twenty patients with achalasia previously treated by cardiomyotomy, were retrospectively studied. The etiology of symptoms recurrence was reflux esophagitis in nine (45.0%) patients, healing of the myotomy in five (25.0%), end staging megaesophagus in five (25.0%) and incomplete myotomy in one (5%). Intra and postoperative complications were analyzed. The patients were studied by clinical (dysphagia, regurgitation, heartburn and weight gain), radiological and endoscopic evaluation, in the pre- and postoperative period. RESULTS: Five (25.0%) patients had complications in the immediate postoperative period. No deaths were observed. Dysphagia improved in all the patients. Regurgitation and heartburn almost disappeared in the whole group. Weight was maintained or increased in 64.7% of the patients. Radiological studies showed a decrease in the caliber of the esophagus in 53.0%, while the remaining patients maintained the pre-operative diameter. Endoscopy, performed during the late postoperative period in 17 patients, showed that 6 among the 9 with reflux esophagitis improved; 2 among the 8 with a normal esophagus during the preoperative period, developed esophagitis. CONCLUSIONS: The Serra-Dória procedure for the treatment of megaesophagus in patients who had already undergone cardiomyotomy and whose symptoms recurred, presented a low morbidity and no mortality. It offered a significant relief of symptoms with a decrease of the caliber of the esophagus in several patients. The patients also improved with regards to reflux esophagitis. In some cases reflux was still present after surgery. Others with normal esophagus in the preoperative period developed esophagitis. |
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Cardioplasty and Roux-en-Y partial gastrectomy (Serra-Dória procedure) for reoperation of achalasiaEsophageal achalasia/surgeryGastrectomyEsophagectomyAnastomosis, Roux-en-YBACKGROUND: After cardiomyotomy for the treatment of megaesophagus, recurrence of symptoms occur in up to 15% of the patients, but only some require a reoperation. AIM: To evaluate the results of reoperation - cardioplasty with Roux-en-Y partial gastrectomy, a technique proposed by Serra-Dória. CASUISTIC AND METHODS: Twenty patients with achalasia previously treated by cardiomyotomy, were retrospectively studied. The etiology of symptoms recurrence was reflux esophagitis in nine (45.0%) patients, healing of the myotomy in five (25.0%), end staging megaesophagus in five (25.0%) and incomplete myotomy in one (5%). Intra and postoperative complications were analyzed. The patients were studied by clinical (dysphagia, regurgitation, heartburn and weight gain), radiological and endoscopic evaluation, in the pre- and postoperative period. RESULTS: Five (25.0%) patients had complications in the immediate postoperative period. No deaths were observed. Dysphagia improved in all the patients. Regurgitation and heartburn almost disappeared in the whole group. Weight was maintained or increased in 64.7% of the patients. Radiological studies showed a decrease in the caliber of the esophagus in 53.0%, while the remaining patients maintained the pre-operative diameter. Endoscopy, performed during the late postoperative period in 17 patients, showed that 6 among the 9 with reflux esophagitis improved; 2 among the 8 with a normal esophagus during the preoperative period, developed esophagitis. CONCLUSIONS: The Serra-Dória procedure for the treatment of megaesophagus in patients who had already undergone cardiomyotomy and whose symptoms recurred, presented a low morbidity and no mortality. It offered a significant relief of symptoms with a decrease of the caliber of the esophagus in several patients. The patients also improved with regards to reflux esophagitis. In some cases reflux was still present after surgery. Others with normal esophagus in the preoperative period developed esophagitis.Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. 2004-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032004000300004Arquivos de Gastroenterologia v.41 n.3 2004reponame:Arquivos de gastroenterologia (Online)instname:Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologiainstacron:IBEPEGE10.1590/S0004-28032004000300004info:eu-repo/semantics/openAccessPonciano,HelioCecconello,IvanAlves,LeosarteFerreira,Berivaldo DiasGama-Rodrigues,Joaquimeng2005-01-21T00:00:00Zoai:scielo:S0004-28032004000300004Revistahttp://www.scielo.br/aghttps://old.scielo.br/oai/scielo-oai.php||secretariaarqgastr@hospitaligesp.com.br1678-42190004-2803opendoar:2005-01-21T00:00Arquivos de gastroenterologia (Online) - Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologiafalse |
dc.title.none.fl_str_mv |
Cardioplasty and Roux-en-Y partial gastrectomy (Serra-Dória procedure) for reoperation of achalasia |
title |
Cardioplasty and Roux-en-Y partial gastrectomy (Serra-Dória procedure) for reoperation of achalasia |
spellingShingle |
Cardioplasty and Roux-en-Y partial gastrectomy (Serra-Dória procedure) for reoperation of achalasia Ponciano,Helio Esophageal achalasia/surgery Gastrectomy Esophagectomy Anastomosis, Roux-en-Y |
title_short |
Cardioplasty and Roux-en-Y partial gastrectomy (Serra-Dória procedure) for reoperation of achalasia |
title_full |
Cardioplasty and Roux-en-Y partial gastrectomy (Serra-Dória procedure) for reoperation of achalasia |
title_fullStr |
Cardioplasty and Roux-en-Y partial gastrectomy (Serra-Dória procedure) for reoperation of achalasia |
title_full_unstemmed |
Cardioplasty and Roux-en-Y partial gastrectomy (Serra-Dória procedure) for reoperation of achalasia |
title_sort |
Cardioplasty and Roux-en-Y partial gastrectomy (Serra-Dória procedure) for reoperation of achalasia |
author |
Ponciano,Helio |
author_facet |
Ponciano,Helio Cecconello,Ivan Alves,Leosarte Ferreira,Berivaldo Dias Gama-Rodrigues,Joaquim |
author_role |
author |
author2 |
Cecconello,Ivan Alves,Leosarte Ferreira,Berivaldo Dias Gama-Rodrigues,Joaquim |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Ponciano,Helio Cecconello,Ivan Alves,Leosarte Ferreira,Berivaldo Dias Gama-Rodrigues,Joaquim |
dc.subject.por.fl_str_mv |
Esophageal achalasia/surgery Gastrectomy Esophagectomy Anastomosis, Roux-en-Y |
topic |
Esophageal achalasia/surgery Gastrectomy Esophagectomy Anastomosis, Roux-en-Y |
description |
BACKGROUND: After cardiomyotomy for the treatment of megaesophagus, recurrence of symptoms occur in up to 15% of the patients, but only some require a reoperation. AIM: To evaluate the results of reoperation - cardioplasty with Roux-en-Y partial gastrectomy, a technique proposed by Serra-Dória. CASUISTIC AND METHODS: Twenty patients with achalasia previously treated by cardiomyotomy, were retrospectively studied. The etiology of symptoms recurrence was reflux esophagitis in nine (45.0%) patients, healing of the myotomy in five (25.0%), end staging megaesophagus in five (25.0%) and incomplete myotomy in one (5%). Intra and postoperative complications were analyzed. The patients were studied by clinical (dysphagia, regurgitation, heartburn and weight gain), radiological and endoscopic evaluation, in the pre- and postoperative period. RESULTS: Five (25.0%) patients had complications in the immediate postoperative period. No deaths were observed. Dysphagia improved in all the patients. Regurgitation and heartburn almost disappeared in the whole group. Weight was maintained or increased in 64.7% of the patients. Radiological studies showed a decrease in the caliber of the esophagus in 53.0%, while the remaining patients maintained the pre-operative diameter. Endoscopy, performed during the late postoperative period in 17 patients, showed that 6 among the 9 with reflux esophagitis improved; 2 among the 8 with a normal esophagus during the preoperative period, developed esophagitis. CONCLUSIONS: The Serra-Dória procedure for the treatment of megaesophagus in patients who had already undergone cardiomyotomy and whose symptoms recurred, presented a low morbidity and no mortality. It offered a significant relief of symptoms with a decrease of the caliber of the esophagus in several patients. The patients also improved with regards to reflux esophagitis. In some cases reflux was still present after surgery. Others with normal esophagus in the preoperative period developed esophagitis. |
publishDate |
2004 |
dc.date.none.fl_str_mv |
2004-09-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032004000300004 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032004000300004 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S0004-28032004000300004 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. |
publisher.none.fl_str_mv |
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. |
dc.source.none.fl_str_mv |
Arquivos de Gastroenterologia v.41 n.3 2004 reponame:Arquivos de gastroenterologia (Online) instname:Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia instacron:IBEPEGE |
instname_str |
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia |
instacron_str |
IBEPEGE |
institution |
IBEPEGE |
reponame_str |
Arquivos de gastroenterologia (Online) |
collection |
Arquivos de gastroenterologia (Online) |
repository.name.fl_str_mv |
Arquivos de gastroenterologia (Online) - Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia |
repository.mail.fl_str_mv |
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1754193343387009024 |