NEW APPROACH TO ESOPHAGOCARDIOMYOTOMY - REPORT OF 40 CASES

  • 1 January 1982
    • journal article
    • research article
    • Vol. 84  (4) , 575-578
Abstract
The major postoperative complications of esophagocardiomyotomy (ECM) for achalasia are peptic esophagitis due to gastroesophageal reflux and recurrence. According to other authors, the incidence of postoperative esophagitis is 15-25%. The results obtained in 40 patients treated by the authors'' surgical technique, which is based on precise anatomic and physiopathological criteria, are reported. With this technique an ECM without esophagogastric mobilization is performed via a lower thoracotomy with partial perihiatal phrenotomy. There were no intraoperative or postoperative deaths. Two patients had postoperative basal pleurisy which was cured easily in a short time. In 36 of these patients, a follow-up ranging between 15 yr-6 mo. revealed a complete remission of dysphagia. The patients had significant and speedy improvement in their general condition. Seven patients had substernal pyrosis when lying down, but this was relieved in a few months in 6 of them. In only 1 patient did it persist for 4 yr after the operation. pH-manometric serial control studies performed in all the patients revealed, except in 1 case, normal pressure and pH values in the lower esophagus. Because of these results, this ECM technique is apparently very effective in the treatment of achalasia.

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