Thoracoscopic esophageal myotomy in the treatment of achalasia
| Autor: | Lawrence Way, Marco G. Patti, James W. Ostroff, Rhoda Leichter, Carlos A. Pellegrini, Kenneth A. Somberg |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Pulmonary and Respiratory Medicine
Myotomy Male medicine.medical_specialty Time Factors medicine.medical_treatment Achalasia Esophagus Postoperative Complications Swallowing medicine Thoracoscopy Humans Hernia medicine.diagnostic_test Esophageal disease business.industry Length of Stay Middle Aged medicine.disease Surgery Esophageal Achalasia medicine.anatomical_structure Esophagectomy Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Annals of thoracic surgery. 56(3) |
| ISSN: | 0003-4975 |
| Popis: | We treated 24 patients with achalasia using thoracoscopic (22 patients) or laparoscopic (2 patients) esophagomyotomy. The only operative complications were mucosal lacerations, which occurred in 3 patients and required conversion to an open procedure in 2. Twenty-two (91%) patients were eating by the second postoperative day. Analgesics were only required for the management of pain from the chest tube, which remained in place for a median time of 24 hours. The median postoperative hospital stay was 3 days (range, 20 to 14 days). The myotomy proved to be incomplete in the first 3 patients, who required a second myotomy; this was done laparoscopically in 2. One patient had a paraesophageal hernia repaired 6 months after the myotomy, and 1 patient required an esophagectomy 1 year after the myotomy for a large nonfunctioning esophagus. Late follow-up showed that swallowing was excellent in 17 (71%) and fair to good in 4 (17%). Sixteen (66%) of these 24 patients have regained their original weight. Thus, excellent to good results were ultimately obtained in nearly 90% of the patients. These results suggest that esophageal myotomy performed using minimally invasive techniques appears to be the treatment of choice for achalasia. |
| Databáze: | OpenAIRE |
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