Esofagectomia trans-hiatal no tratamento do megaesôfago chagásico avançado

Neto, João Batista; Fontan, A; Nepomuceno, Marcos da Costa; Lourenço, Laércio Gomes; Ribeiro, Laércio Tenório; Ramos, Carmen Pereira

doi:10.1590/s0100-69912003000300011

Cited by 4 publications

(7 citation statements)

References 8 publications

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“…The experience of our Service with transhiatal esophagectomy was started in 1982 and revolves around a hundred cases, for benign and malignant diseases, through laparoscopic or open accesses. The incidence of fistulae was 32% at the start and dropped to 13.3% and 25% of the fistulae needed 1-3 dilatation sessions 4 .…”

Section: Technique Technique Technique Technique Techniquementioning

confidence: 91%

Anastomose mecânica esofagogástrica cervical látero-lateral após esofagectomias

Neto

Morais²,

Nepomuceno³

et al. 2013

Rev. Col. Bras. Cir.

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Section: Technique Technique Technique Technique Techniquementioning

confidence: 91%

Anastomose mecânica esofagogástrica cervical látero-lateral após esofagectomias

Neto

Morais²,

Nepomuceno³

et al. 2013

Rev. Col. Bras. Cir.

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“…However, they pointed out that in the study performed there were two cases of aspiration and both were fatal. The same occurred in this study and the service adopted pyloroplasty in every transposed stomach 6 . Stasis appears even in those submitted to pyloroplasty, but afterwards it disappears 3 , 6 .…”

Section: Discussionmentioning

confidence: 70%

“…There is no consensus among surgeons 16 , which is the best technique for the treatment of advanced forms of megaesophagus 2 , 4 , 6 , 14 , 15 , 18 , 21 . Resection and cardioplasties, in their various techniques, are discussed among themselves.…”

Section: Discussionmentioning

confidence: 99%

“…The ones that offer better results in the resolution of dysphagia present higher morbidity and mortality, and those with lower, increase the rate of relapse of the clinical aspects, with possible new interventions 2 , 4 , 14 , 18 . Open-access trans-hiatal esophagectomy, as an option for the treatment of advanced megaesophagus, has been consolidated 6 , 14 , 21 . In the 1990s, surgical diseases were impacted by videolaparoscopic access, reducing morbidity and favoring early recovery.…”

Section: Introductionmentioning

confidence: 99%

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Minimally Invasive Laparoscopic Esophagectomy vs. Transhiatal Open Esophagectomy in Achalasia: A Randomized Study

Fontan

Batista-Neto

Pontes

et al. 2018

ABCD, arq. bras. cir. dig.

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Background:Open and laparoscopic trans-hiatal esophagectomy has been successfully performed in the treatment of megaesophagus. However, there are no randomized studies to differentiate them in their results. Aim:To compare the results of minimally invasive laparoscopic esophagectomy (EMIL) vs. open trans-hiatal esophagectomy (ETHA) in advanced megaesophagus. Method:A total of 30 patients were randomized, 15 of them in each group - EMIL and ETHA. The studied variables were dysphagia score before and after the operation at 24-months follow-up; pain score in the immediate postoperative period and at hospital discharge; complications of the procedure, comparing each group. Were also studied: surgical time in minutes, transfusion of blood products, length of hospital stay, mortality and follow-up time. Results:ETHA group comprised eight men and seven women; in the EMIL group, four women and 11 men. The median age in the ETHA group was 47.2 (29-68) years, and in the EMIL group of 44.13 (20-67) years. Mean follow-up time was 33 months, with one death in each group, both by fatal aspiration. There was no statistically significant difference between the EMIL vs. ETHA scores for dysphagia, pain and in-hospital complications. The same was true for surgical time, transfusion of blood products and hospital stay. Conclusion:There was no difference between EMIL and ETHA in all the studied variables, thus allowing them to be considered equivalent.

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“…Considering our findings regarding the clinical aspects -dysphagia, heartburn, aspiration, weight loss and nutritional status -, we can say that esophagectomy in advanced megaesophagus provides good quality of life in Table 1 Table 1 Table 1 Table 1 Table 1 Pochini Pochini Pochini Pochini Pochini Esophagectomy with gastroplasty in advanced megaesophagus: late results of omeprazole use the short and medium term, especially as for the nutritional aspect 11,20,21,28,32 . It is worth remembering that 80% of patients were asymptomatic and did not complain of heartburn.…”

Section: Discussion Discussion Discussion Discussionmentioning

confidence: 84%

Esophagectomy with gastroplasty in advanced megaesophagus: late results of omeprazole use

Pochini¹,

Gagliardi²,

Júnior³

et al. 2015

Rev. Col. Bras. Cir.

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Objective: To analyze the late results of advanced Chagasic megaesophagus treatment by esophagectomy associated with the use of proton pump inhibitor (omeprazole) as for the incidence of esophagitis and Barrett's esophagus in the remaining stump. Methods : We studied patients with advanced megaesophagus undergoing esophagectomy and transmediastinal esophagogastroplasty. Patients were divided into three groups: A (20) with esophageal replacement by full stomach, without the use of omeprazole; B (20) with esophageal replacement by full stomach, with omeprazole 40 mg/day introduced after the first postoperative endoscopy and maintained for six years; and C (30) with esophageal replacement by gastric tube with use of omeprazole. Dysphagia, weight loss and BMI were clinical parameters we analyzed. Upper gastrointestinal endoscopy was performed in all patients, and determined the height of the anastomosis, the aspect of the mucosa, with special attention to possible injuries arising from gastroesophageal reflux, and the patency of the esophagogastric anastomosis. Results : We studied 50 patients, 28 males (56%) and 22 (44%) females. All underwent endoscopy every year. In the first endoscopy, erosive esophagitis was present in nine patients (18%) and Barrett's esophagus, in four (8%); in the last endoscopy, erosive esophagitis was present in five patients (8%) and Barrett's esophagus in one (2%). When comparing groups B and C, there was no evidence that the manufacturing of a gastric tube reduced esophagitis and Barrett's esophagus. However, when comparing groups A and C, omeprazole use was correlated with reduction of reflux complications such as esophagitis and Barrett's esophagus (p <0.005). Conclusion : The use of omeprazole (40 mg/day) reduced the onset of erosive esophagitis and Barrett's esophagus during the late postoperative period.

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Esofagectomia trans-hiatal no tratamento do megaesôfago chagásico avançado

Cited by 4 publications

References 8 publications

Anastomose mecânica esofagogástrica cervical látero-lateral após esofagectomias

Anastomose mecânica esofagogástrica cervical látero-lateral após esofagectomias

Minimally Invasive Laparoscopic Esophagectomy vs. Transhiatal Open Esophagectomy in Achalasia: A Randomized Study

Esophagectomy with gastroplasty in advanced megaesophagus: late results of omeprazole use

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