Abstract | BACKGROUND: In 1989, we predicted an increasing number of esophagectomies for megaesophagus and for recurrent symptoms after prior esophagomyotomy or balloon dilatation for achalasia. Patient selection in this group is challenging, as the potential operative morbidity of an esophagectomy must be weighed against the expected clinical outcome after a redo esophagomyotomy or alternative procedures designed to salvage the native esophagus. METHODS: The hospital records of 93 patients undergoing esophagectomy for achalasia during the past 20 years were reviewed retrospectively and the results of operation assessed using our prospectively established Esophageal Resection Database and follow-up information obtained through personal contact with the patients. RESULTS: CONCLUSIONS:
Esophagectomy, preferably through a transhiatal approach, is generally safe and effective therapy in selected patients with achalasia. Unique technical considerations include difficulty encircling the dilated cervical esophagus, deviation of the esophagus into the right chest, large aortic esophageal arteries, and adherence of the exposed esophageal submucosa to the adjacent aorta after prior myotomy.
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Authors | E J Devaney, M D Lannettoni, M B Orringer, B Marshall |
Journal | The Annals of thoracic surgery
(Ann Thorac Surg)
Vol. 72
Issue 3
Pg. 854-8
(Sep 2001)
ISSN: 0003-4975 [Print] Netherlands |
PMID | 11565670
(Publication Type: Journal Article)
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Esophageal Achalasia
(etiology, surgery)
- Esophagectomy
(adverse effects, methods)
- Esophagoplasty
- Female
- Humans
- Length of Stay
- Male
- Middle Aged
- Patient Satisfaction
- Recurrence
- Retrospective Studies
- Treatment Outcome
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