Laparoscopic Heller Myotomy and Fundoplication in Patients with Chagas' Disease Achalasia and Massively Dilated Esophagus

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dc.contributor.authorPantanali, Carlos A. R.
dc.contributor.authorHerbella, Fernando A. M.
dc.contributor.authorHenry, Maria A. [UNESP]
dc.contributor.authorMattos Farah, Jose Francisco
dc.contributor.authorPatti, Marco G.
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionHosp Servidor Publ Estadual Sao Paulo Francisco M
dc.contributor.institutionUniv Chicago
dc.date.accessioned2014-12-03T13:10:29Z
dc.date.available2014-12-03T13:10:29Z
dc.date.issued2013-01-01
dc.description.abstractLaparoscopic Heller myotomy and fundoplication is considered today the treatment of choice for achalasia. The optimal treatment for end-stage achalasia with esophageal dilation is still controversial. This multicenter and retrospective study aims to evaluate the outcome of laparoscopic Heller myotomy in patients with a massively dilated esophagus. Eleven patients (mean age, 56 years; 6 men) with massively dilated esophagus (esophageal diameter greater than 10 cm) underwent a laparoscopic Heller myotomy and anterior fundoplication between 2000 and 2009 at three different institutions. Preoperative workup included upper endoscopy, esophagram, and esophageal manometry in all patients. Average follow-up was 31.5 months (range, 3 to 60 months). Two patients (18%) had severe dysphagia, four patients (36%) had mild and occasional dysphagia to solid food, and five patients (45%) were asymptomatic. All patients gained or kept body weight, except for the two patients with severe dysphagia. Of the two patients with severe dysphagia, one underwent esophageal dilatation and the other a laparoscopic esophagectomy. They are both doing well. Heller myotomy relieves dysphagia in the majority of patients even when the esophagus is massively dilated.en
dc.description.affiliationUniv Fed Sao Paulo, Dept Surg, Escola Paulista Med, Sao Paulo, Brazil
dc.description.affiliationState Univ Sao Paulo, Dept Surg & Orthoped, Botucatu, SP, Brazil
dc.description.affiliationHosp Servidor Publ Estadual Sao Paulo Francisco M, Dept Surg, Sao Paulo, Brazil
dc.description.affiliationUniv Chicago, Dept Surg, Chicago, IL 60637 USA
dc.description.affiliationUnespState Univ Sao Paulo, Dept Surg & Orthoped, Botucatu, SP, Brazil
dc.format.extent72-75
dc.identifierhttp://www.ingentaconnect.com/content/sesc/tas/2013/00000079/00000001/art00033
dc.identifier.citationAmerican Surgeon. Cumming: Southeastern Surgical Congress, v. 79, n. 1, p. 72-75, 2013.
dc.identifier.issn0003-1348
dc.identifier.urihttp://hdl.handle.net/11449/112182
dc.identifier.wosWOS:000336961200033
dc.language.isoeng
dc.publisherSoutheastern Surgical Congress
dc.relation.ispartofAmerican Surgeon
dc.relation.ispartofjcr0.607
dc.relation.ispartofsjr0,405
dc.rights.accessRightsAcesso restrito
dc.sourceWeb of Science
dc.titleLaparoscopic Heller Myotomy and Fundoplication in Patients with Chagas' Disease Achalasia and Massively Dilated Esophagusen
dc.typeArtigo
dcterms.rightsHolderSoutheastern Surgical Congress
unesp.author.orcid0000-0003-3594-5744[2]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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