Complex treatment of patients with achalasia of cardia and cardiospasm subject to psychosomatic disorders

Autor: Chernousov Af, Khorobrykh Tv, V. A. Dulova, S V Osminin, F P Vetshev, L. V. Romasenko
Rok vydání: 2018
Předmět:
Zdroj: Clinical Medicine (Russian Journal). 96:419-426
ISSN: 2412-1339
0023-2149
Popis: Achalasia of cardia and cardiospasm are neuromuscular diseases characterized by functional disorders of the permeability of the esophageal-gastric junction, their prevalence is up to 22% of all diseases of the esophagus. The article presents a series of clinical studies of 114 patients with achalasia of cardia and cardiospasm since 2006. A modified algorithm for the examination and treatment ofpatients with different stages of the disease is presented. The balloon cardiodilation, as the main method of treatment, was carried out by 76 patients. Surgical treatment was performed in 36 patients: 17 patients with stage III performed esophagocardiomyotomy with incomplete fundoplication in the modification of A.F. Chernousov, 19 - with the IV stage transhiatal extirpation of the esophagus with gastroplasty was performed. A group of 26 patients with psychosomatic disorders was selected, who, in addition to traditional surgical treatment, underwent psychotropic therapy. Good immediate and long-term results of complex treatment were obtained. Substantially faster relief of symptoms of dysphagia and other complaintsfrom the gastrointestinal tract was noted, a more persistent and prolonged effect of dilation sessions and a significant improvement in the quality of life compared with patients who did not receive psychotropic drugs. In this group of patients, we did not observe any recurrence of the disease after the dilatation sessions. The control examination (endoscopic and X-ray examination of the upper gastrointestinal tract, manometry) revealed no signs of dysphagia or gastroesophageal reflux in any patient, including among the operated.
Databáze: OpenAIRE
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