Achalasia of the cardia: Long-term results of oesophagomyotomy and posterior partial fundoplication
| Autor: | L F Martinez de Haro, P. Parrilla Paricio, A Ortiz, Aguayo Jl |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Adult
Male Myotomy medicine.medical_specialty Time Factors Adolescent Manometry medicine.medical_treatment Achalasia Asymptomatic Gastroenterology Esophagus Internal medicine Humans Medicine Gastric Fundus Aged Peristalsis Gastric fundus business.industry Reflux Muscle Smooth Long term results Hydrogen-Ion Concentration Middle Aged medicine.disease Dysphagia digestive system diseases Surgery Esophageal Achalasia Female medicine.symptom business |
| Zdroj: | British Journal of Surgery. 77:1371-1374 |
| ISSN: | 1365-2168 0007-1323 |
| Popis: | Forty-eight patients with achalasia of the cardia were treated by Heller's myotomy with a posterior fundoplication of approximately 270°, suturing the gastric fundus to the edges of the myotomy. The mean(s.d.) postoperative follow-up period was 5·4(2·8) years. The clinical results were good to excellent in 44 cases (92 per cent) and fair in four cases (8 per cent) (two with residual dysphagia and two with gastro-oesophageal reflux). Barium studies showed a decrease in oesophageal diameter and disappearance of distal narrowing but normal oesophageal emptying did not occur. Postoperative manometric studies (29 patients) revealed a significant decrease in lower oesophageal sphincter pressure and a significant increase in the length of the infradiaphragmatic segment. In the oesophageal body a recovery of peristaltic waves in the proximal third was seen in ten of the patients (34 per cent). Twenty-four-hour pH monitoring showed pathological reflux in only three of 25 patients studied, and one of these was asymptomatic. This technique is effective, improving oesophageal symptoms and controlling long-term reflux. |
| Databáze: | OpenAIRE |
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