Abdominal esophagocardiectomy with esophagogastric anastomosis, with vagal preservation and construction of a spiral anti reflux valve in the treatment of advanced megaesophagus.

Autor:	Contrucci Filho O; - Universidade Santo Amaro, Cirurgia - São Paulo - SP - Brasil.; - International Society for Diseases of the Esophagus - Vancouver - Canadá., Freitas CM; - Universidade Santo Amaro, Cirurgia - São Paulo - SP - Brasil.; - Colégio Brasileiro de Cirurgiões - São Paulo - SP - Brasil., Ilias EJ; - Universidade Santo Amaro, Cirurgia - São Paulo - SP - Brasil.; - Colégio Brasileiro de Cirurgiões - São Paulo - SP - Brasil.; - Colégio Brasileiro de Cirurgia Digestiva - São Paulo - SP - Brasil.; - Sociedade Brasileira de Cirurgia Bariátrica e Metabólica - São Paulo - SP - Brasil., Fonseca AZ; - Hospital Regional Sul, Cirurgia - São Paulo - SP - Brasil.; - Colégio Brasileiro de Cirurgia Digestiva - São Paulo - SP - Brasil.
Jazyk:	English; Portuguese
Zdroj:	Revista do Colegio Brasileiro de Cirurgioes [Rev Col Bras Cir] 2022 Sep 19; Vol. 49, pp. e20223222. Date of Electronic Publication: 2022 Sep 19 (Print Publication: 2022).
DOI:	10.1590/0100-6991e-20223222_en
Abstrakt:	Objective: present a new operative technique characterized by abdominal esophagocardiectomy, with esophagogastrus anastomosis, vagal preservation and spiral anti-reflux valve construction in the treatment of advanced megaesophagus in patients with severe systemic diseases, as well as its result in an initial group of 17 patients. Method: We selected 17 patients with advanced megaesophagus and comorbidities submitted to new technique. The following parameters were analyzed: age, sex, length of hospital stay, early and late complications, mortality, radiological/endoscopic aspects. Results: twelve male patients (70%) and five (30%) were operated on, with mean age of 51.5 years and mean hospital stay of 14.8 days. There was no mortality in the immediate intraoperative or postoperative period and there were no cases of postoperative fistula. During hospitalization there was one case of pulmonary atelectasis (5.8%), one of pleural effusion (5.8%), two of wall infection (11.7%) and one of urinary retention (5.8%). Discussion: We believe it to be an easy technique, made exclusively by the abdominal route, that is, without violating the thoracic cavity. Such a procedure would be beneficial in patients with advanced megaesophagus and important comorbidities, as well as in those with a history of previous surgeries. Conclusion: the technique described was easy to perform and safe, when performed by an experienced team, with low morbidity and mortality in patients with advanced megaesophagus and important comorbidities, which could increase your complications with more invasive and complex surgeries.
Databáze:	MEDLINE
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