Laparoscopic heller myotomy and fundoplication in patients with chagas disease achalasia and massively dilated esophagus
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://hdl.handle.net/11449/231297 |
Resumo: | Laparoscopic Heller myotomy and fundoplication is considered today the treatment of choice for achalasia. The optimal treatment for end-stage achalasia with esophageal dilation is still controversial. This multicenter and retrospective study aims to evaluate the outcome of laparoscopic Heller myotomy in patients with a massively dilated esophagus. Eleven patients (mean age, 56 years; 6 men) with massively dilated esophagus (esophageal diameter greater than 10 cm) underwent a laparoscopic Heller myotomy and anterior fundoplication between 2000 and 2009 at three different institutions. Preoperative workup included upper endoscopy, esophagram, and esophageal manometry in all patients. Average follow-up was 31.5 months (range, 3 to 60 months). Two patients (18%) had severe dysphagia, four patients (36%) had mild and occasional dysphagia to solid food, and five patients (45%) were asymptomatic. All patients gained or kept body weight, except for the two patients with severe dysphagia. Of the two patients with severe dysphagia, one underwent esophageal dilatation and the other a laparoscopic esophagectomy. They are both doing well. Heller myotomy relieves dysphagia in the majority of patients even when the esophagus is massively dilated. Copyright Southeastern Surgical Congress. All rights reserved. |
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Laparoscopic heller myotomy and fundoplication in patients with chagas disease achalasia and massively dilated esophagusLaparoscopic Heller myotomy and fundoplication is considered today the treatment of choice for achalasia. The optimal treatment for end-stage achalasia with esophageal dilation is still controversial. This multicenter and retrospective study aims to evaluate the outcome of laparoscopic Heller myotomy in patients with a massively dilated esophagus. Eleven patients (mean age, 56 years; 6 men) with massively dilated esophagus (esophageal diameter greater than 10 cm) underwent a laparoscopic Heller myotomy and anterior fundoplication between 2000 and 2009 at three different institutions. Preoperative workup included upper endoscopy, esophagram, and esophageal manometry in all patients. Average follow-up was 31.5 months (range, 3 to 60 months). Two patients (18%) had severe dysphagia, four patients (36%) had mild and occasional dysphagia to solid food, and five patients (45%) were asymptomatic. All patients gained or kept body weight, except for the two patients with severe dysphagia. Of the two patients with severe dysphagia, one underwent esophageal dilatation and the other a laparoscopic esophagectomy. They are both doing well. Heller myotomy relieves dysphagia in the majority of patients even when the esophagus is massively dilated. Copyright Southeastern Surgical Congress. All rights reserved.Department of Surgery Escola Paulista de Medicina Federal University of São Paulo, Rua Diogo de Faria 1087 cj 301, São Paulo, SP, 04037-003Department of Surgery and Orthopedics State University of São Paulo, Botucatu, SPDepartment of Surgery Hospital do Servidor Pu blico Estadual São Paulo Francisco Morato de Oliveira, São Paulo, SPDepartment of Surgery University of Chicago, Chicago, ILUniversidade de São Paulo (USP)São Paulo Francisco Morato de OliveiraUniversity of ChicagoPantanali, Carlos A. R.Herbella, Fernando A. M.Henry, Maria A.Farah, Jose Francisco MattosPatti, Marco G.2022-04-29T08:44:32Z2022-04-29T08:44:32Z2013-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article72-75American Surgeon, v. 79, n. 1, p. 72-75, 2013.0003-1348http://hdl.handle.net/11449/2312972-s2.0-84875079401Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengAmerican Surgeoninfo:eu-repo/semantics/openAccess2022-04-29T08:44:32Zoai:repositorio.unesp.br:11449/231297Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462022-04-29T08:44:32Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Laparoscopic heller myotomy and fundoplication in patients with chagas disease achalasia and massively dilated esophagus |
title |
Laparoscopic heller myotomy and fundoplication in patients with chagas disease achalasia and massively dilated esophagus |
spellingShingle |
Laparoscopic heller myotomy and fundoplication in patients with chagas disease achalasia and massively dilated esophagus Pantanali, Carlos A. R. |
title_short |
Laparoscopic heller myotomy and fundoplication in patients with chagas disease achalasia and massively dilated esophagus |
title_full |
Laparoscopic heller myotomy and fundoplication in patients with chagas disease achalasia and massively dilated esophagus |
title_fullStr |
Laparoscopic heller myotomy and fundoplication in patients with chagas disease achalasia and massively dilated esophagus |
title_full_unstemmed |
Laparoscopic heller myotomy and fundoplication in patients with chagas disease achalasia and massively dilated esophagus |
title_sort |
Laparoscopic heller myotomy and fundoplication in patients with chagas disease achalasia and massively dilated esophagus |
author |
Pantanali, Carlos A. R. |
author_facet |
Pantanali, Carlos A. R. Herbella, Fernando A. M. Henry, Maria A. Farah, Jose Francisco Mattos Patti, Marco G. |
author_role |
author |
author2 |
Herbella, Fernando A. M. Henry, Maria A. Farah, Jose Francisco Mattos Patti, Marco G. |
author2_role |
author author author author |
dc.contributor.none.fl_str_mv |
Universidade de São Paulo (USP) São Paulo Francisco Morato de Oliveira University of Chicago |
dc.contributor.author.fl_str_mv |
Pantanali, Carlos A. R. Herbella, Fernando A. M. Henry, Maria A. Farah, Jose Francisco Mattos Patti, Marco G. |
description |
Laparoscopic Heller myotomy and fundoplication is considered today the treatment of choice for achalasia. The optimal treatment for end-stage achalasia with esophageal dilation is still controversial. This multicenter and retrospective study aims to evaluate the outcome of laparoscopic Heller myotomy in patients with a massively dilated esophagus. Eleven patients (mean age, 56 years; 6 men) with massively dilated esophagus (esophageal diameter greater than 10 cm) underwent a laparoscopic Heller myotomy and anterior fundoplication between 2000 and 2009 at three different institutions. Preoperative workup included upper endoscopy, esophagram, and esophageal manometry in all patients. Average follow-up was 31.5 months (range, 3 to 60 months). Two patients (18%) had severe dysphagia, four patients (36%) had mild and occasional dysphagia to solid food, and five patients (45%) were asymptomatic. All patients gained or kept body weight, except for the two patients with severe dysphagia. Of the two patients with severe dysphagia, one underwent esophageal dilatation and the other a laparoscopic esophagectomy. They are both doing well. Heller myotomy relieves dysphagia in the majority of patients even when the esophagus is massively dilated. Copyright Southeastern Surgical Congress. All rights reserved. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-01-01 2022-04-29T08:44:32Z 2022-04-29T08:44:32Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
American Surgeon, v. 79, n. 1, p. 72-75, 2013. 0003-1348 http://hdl.handle.net/11449/231297 2-s2.0-84875079401 |
identifier_str_mv |
American Surgeon, v. 79, n. 1, p. 72-75, 2013. 0003-1348 2-s2.0-84875079401 |
url |
http://hdl.handle.net/11449/231297 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
American Surgeon |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
72-75 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
_version_ |
1803046958342864896 |