Comparative pre- and postoperative results analysis of functional state of the esophagus assessment in patients with various stages of achalasia☆

Оноприев, В. И.; Дурлештер, В. М.; Ryabchun, Vadim Valerevich

doi:10.1016/j.ejcts.2005.02.037

Cited by 12 publications

(11 citation statements)

References 18 publications

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“…However, we could not find in the literature a unified criterion to classify success and failure of the surgical procedure. Some authors use a decrease in PLES 26 as the criterion, while others use criteria based on symtoms listed in questionnaire schemes with a scale of points 21,22 similar to the one chosen for the present study. Some authors draw on reports of dysphagia relief as an improvement parameter 27,28 .…”

Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

Qualidade de vida após a cardiomiotomia à Heller-Dor

Madureira¹,

Madureira²,

Loss³

et al. 2009

Rev. Col. Bras. Cir.

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, were studied retrospectively. Before surgery, the demographics and the diagnostic test results were recorded. The patients submitted a dysphagia score for quality of life before and after surgery, and lower esophageal sphincter pressure (PLES) was measured. We also studied the difference produced in quality of life Results:Results: Results: Results: Results: 37 women and 23 men were followed. Mean age was 41.08 (12-87). There was no mortality and no conversions. The mean time of diet resumption was 1.6 day. The outcome was considered excellent in 80% of the series and intermediate in 20% of the series. The mean dysphagia score before surgery was 9.03 points, and after surgery, 1.7 point (maximum of 10 points), p=0.0001. The mean score decrease between pre-and postoperative scores was 7.33 points (87.17%). The mean PLES before surgery was 32.41 mmHg, and 12.7 mmHg after. Conclusion:Conclusion: Conclusion: Conclusion: Conclusion: HDL is a safe procedure and changed significantly the subjective quality of life scores, as well as the objective PLES means.

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Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

Qualidade de vida após a cardiomiotomia à Heller-Dor

Madureira¹,

Madureira²,

Loss³

et al. 2009

Rev. Col. Bras. Cir.

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“…It provides symptoms relief in about 90% of patients with more than 80% remaining dysphagia free at 5 years. 18,46 However, the high cost of this approach, access to reference centers, the need of surgical skills that are not readily available and surgeon learning curve are still an issue. Recently, computer enhanced robotic telesurgery provides further improvement over laparoscopic Heller myotomy.…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…17 In developed countries manometric diagnosis is obtained before therapeutic intervention. 18 The most important finding is aperistalsis of the body of the esophagus in the distal smooth muscle segment of the esophagus. 14,19 Other manometric findings that are characteristic but not necessary for the diagnosis of achalasia are failure or incomplete relaxation of the LES with swallowing, sustained hypertension of the LES and elevated intra esophageal body pressure compared to pressure within the stomach.…”

Section: Introductionmentioning

confidence: 99%

“…14,19 Other manometric findings that are characteristic but not necessary for the diagnosis of achalasia are failure or incomplete relaxation of the LES with swallowing, sustained hypertension of the LES and elevated intra esophageal body pressure compared to pressure within the stomach. 14,18,19 Barium swallow is an important diagnostic tool in patients with symptoms suggestive of achalasia. Fluoroscopy reveals repetitive non-peristaltic contractions of the esophagus.…”

Section: Introductionmentioning

confidence: 99%

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Achalasia: What is the best treatment?

Ahmed

2008

Ann Afr Med

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Background: Achalasia is an infrequent primary motility disorder of the esophagus. Because of uncertain etiology, treatment is only palliative and is directed at decreasing lower esophageal sphincter pressure, improving esophageal emptying and relieving the symptoms of achalasia. Current treatment options include pharmacological, endoscopic and surgical. We undertook a systematic literature review of the management strategies currently available for achalasia. Method: A Medline, PubMed and Cochrane database search was conducted using reference manager 11. Original articles and reviews published in the English literature on the management of achalasia were reviewed. Emphasis was placed on articles published in the last ten years on randomized controlled trials comparing the various forms of treatment. Results: Esophageal manometry is the standard diagnostic evaluation for achalasia. Accurate diagnosis can also be made based on clinical findings and barium esophagogram. Medical treatment with nitrates or calcium channel blockers has variable results in alleviating the symptoms of achalasia but long-term results are disappointing because of tolerance and side effects. Intrasphincteric injection of botulinum toxin, pneumatic dilatation and surgical myotomy are variably effective at controlling the symptoms of achalasia but each modality has specific strength and weaknesses which make their choice suitable in a particular group of patients. While pneumatic dilatation is superior to botulinum toxin injection surgical myotomy provides the best long-term control of symptoms in patients with achalasia. Conclusion: Laparoscopic myotomy should be the initial treatment for most patients with achalasia. Pneumatic dilatation is the most cost-effective alternative but its long-term efficacy is less than that of surgical myotomy. Endoscopic botulinum toxin injection can be considered when other forms of treatment are contraindicated. Key words: Achalasia, Heller's esophagomyotomy, pneumatic dilatationRésumé Contexte: L'achalasie est une rare anomalie motrice de l'oesophage. En raison de son étiologie incertaine, le traitement est seulement palliatif et vise la réduire la pression sphinctérienne du bas oesophage, l'amélioration de la vidange et le soulagement des symptômes de l'achalasie. Les options thérapeutiques courantes font appel aux moyens pharmacologiques, endoscopiques et chirurgicaux. Nous avons effectué une revue systématique de la littérature relative aux stratégies thérapeutiques actuellement disponibles pour l'achalasie. Méthode: Une recherche sur Medline, Pubmed et Cochrane a été faite a l'aide du logiciel Reference Manager 11. Les articles originaux et les rapports portant sur la prise en charge de l'achalasie et publiés en anglaise ont été passés en revue. L'accent a été mis sur les articles publiés au cours des dix dernières années et sur les essais contrôlés comparant les diverses formes de traitement. Résultats: La manométrie oesophagienne est la méthode de diagnostic standard pour l'achalasie. Le dia...

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“…There is no consensus on the threshold of esophageal diameter to consider the disease as end-stage. While some adopt the limit in 6 cm [6] , others prefer 7 cm [7] . In Brazil, 4 different stages of esophageal dilatation are considered [8] and end-stage disease is defined by diameterover 10 cm [9] .…”

Section: Introductionmentioning

confidence: 99%

One size fits all: laparoscopic Heller’s myotomy for the treatment of achalasia irrespective of the degree of dilatation

Grande¹,

Herbella²,

Patti³

et al. 2017

MIS

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Laparoscopic Heller's myotomy is the most common surgical procedure to treat achalasia. It is the most accepted therapy for non-advanced stages of the disease. In the setting of advanced disease with marked esophageal dilatation or sigmoid-shaped esophagus the ideal surgical procedure is debatable. Esophagectomy is believed by several authors to be the operation of choice in these cases. Others; however, opt for less invasive alternatives. Laparoscopic Heller's myotomy has been shown to be a safe and resourceful alternative in end-stage achalasia as well. Key words: Achalasia, surgery, myotomy, end-stage disease ABSTRACTArticle history:

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Comparative pre- and postoperative results analysis of functional state of the esophagus assessment in patients with various stages of achalasia☆

Cited by 12 publications

References 18 publications

Qualidade de vida após a cardiomiotomia à Heller-Dor

Qualidade de vida após a cardiomiotomia à Heller-Dor

Achalasia: What is the best treatment?

One size fits all: laparoscopic Heller’s myotomy for the treatment of achalasia irrespective of the degree of dilatation

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