Early and Late Assessment of Esophagocardioplasty in the Surgical Treatment of Advanced Recurrent Megaesophagus

Aquino, José Luiz Braga de; Said, Marcelo Manzano; Pereira, Douglas Alexandre Rizzanti; Leandro-Merhi, Vânia Aparecida; Nascimento, Paula Casals do; Reis, Virgínia Vieitez

doi:10.1590/s0004-28032016000400005

Cited by 7 publications

(3 citation statements)

References 11 publications

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“…Neither treatment; however, seems to be ideal since they do not act directly on the physiopathology of the disease [1][2][3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

Non-conventional surgical approach to achalasia: mucosectomy and endomuscular pull-through

Aquino¹,

Said²,

Camargo³

2017

MIS

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Aim: Transhiatal esophagectomy is a therapeuthic option for the treatment of end-stage achalasia that avoids the complications of a thoracotomy. This technique; however, is still linked to some degree of morbimortality especially due to pleuromediastinal complications. Esophageal mucosectomy and endomuscular pull-through could avoid these complications. This study aims to evaluate the short and long-term outcomes of esophageal mucosectomy and endomuscular pull-through in a series of patients with advanced megaesophagus. Methods: We retrospectively studied 115 patients with end-stage achalasia that underwent esophageal mucosectomy and endomuscular pull-through. Digestive tract reconstruction was accomplished most times using the stomachthourgh the muscular tunnel. Outcomes were evaluated in a short and long-term follow-up based on clinical, endoscopic and tomographic evaluation. Results: Anastomotic leak or stenosis was present in 27%. Pleural efusion was noticed in 11% and pneumonia in 9%. Mortality was 1.7%. Long-term follow-up (over 10 years) was possible in 42 patients. Excellent and good clinical results were obtained in 83% of the patients. Conclusion: Esophageal mucosectomy and endomuscular pull-through is a valuable procedure for the treatment of end-stage achalasia. It shows a low rate of complications and good outcomes at long-term follow-up. Key words:Achalasia, esophagectomy, megaesophagus, mucosectomy ABSTRACTArticle history:

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“…Neither treatment; however, seems to be ideal since they do not act directly on the physiopathology of the disease [1][2][3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

Non-conventional surgical approach to achalasia: mucosectomy and endomuscular pull-through

Aquino¹,

Said²,

Camargo³

2017

MIS

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“…O tratamento é sempre paliativo, seja ele clínico, endoscópico ou cirúrgico, pois não tem ação no fator etiológico da doença, tendo por objetivo somente o alívio sintomático e a profilaxia das complicações. As formas de tratamento incluem: medidas dietético-comportamentais; drogas que diminuam a pressão no esfíncter esofágico inferior, como bloqueadores do canal de cálcio, nitratos; procedimentos endoscópicos, como aplicação de toxina botulínica no esfíncter esofágico inferior, dilatação pneumática da cárdia e, mais recentemente, a miotomia endoscópica peroral; e o tratamento cirúrgico, como esofagocardiomiotomia e esofagectomia (TSUBOI et al, 2015;AQUINO et al, 2016).…”

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Aumento Da Sobrevida De Pacientes Oncológicos Com Cuidado Paliativo Precoce: Revisão De Literatura

Mendes¹,

Menezes²,

Oliveira³

et al. 2020

Difusão Do Conhecimento Através Das Diferentes Áreas Da Medicina 5

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Todo o conteúdo deste livro está licenciado sob uma Licença de Atribuição Creative Commons. Atribuição 4.0 Internacional (CC BY 4.0). O conteúdo dos artigos e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores. Permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores, mas sem a possibilidade de alterá-la de nenhuma forma ou utilizá-la para fins comerciais.

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“…However, mid-term studies have shown that cardioplasties have not always yielded satisfactory results, mainly due to the difficulty in emptying the esophagus, and due to the gastroesophageal reflux that such procedure can trigger [20,[22][23][24]. This fact has been well demonstrated more recently by Aquino et al [25], who evaluated the 5 years late postoperative period in 19 patients with recurrent advanced achalasia who underwent SERRA DORIA cardioplasty and found that only 38.4% of the patients had normal swallowing and 53.8% of them had regurgitation, concluding that this procedure should only be indicated for patients without clinical conditions justifying esophagectomy.…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Esophageal Advanced Achalasia

Aquino¹,

Leandro‐Merhi²

2022

Dysphagia - New Advances

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Of the several procedures that has to treat esophageal achalasia, the esophagectomy is to be the most indicated in advanced disease, which prompted Pinotti the disseminate the transmediastinal esophagectomy technique in the 1970s, with the advantage of avoiding thoracotomy. Nevertheless, several series demonstrated that this technique was not exempt from complications one of which could lead to massive hemopneumothorax due to injury to the trachea- bronchial tree and vessels due the periesophagitis that may be present with consequent adherence of the esophagus to these noble organs. Thus, Aquino in 1996 introduced the esophageal mucosectomy technique with preservation of the esophageal muscle tunic at the level of mediastinum as well as the transposition of the stomach to the cervical region inside in this tunic for the reconstruction of digestive tract. The advantage of this procedure is to avoid transgression of the mediastinum. This author describes in details this procedure, and shows early results and late evaluation using the ECKARDT score in a series of patients showing the advantages of the esophageal mucosectomy due the low incidence of immediate postoperative complications and good resolution in long term due the absence of symptoms in most patients.

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Early and Late Assessment of Esophagocardioplasty in the Surgical Treatment of Advanced Recurrent Megaesophagus

Cited by 7 publications

References 11 publications

Non-conventional surgical approach to achalasia: mucosectomy and endomuscular pull-through

Non-conventional surgical approach to achalasia: mucosectomy and endomuscular pull-through

Aumento Da Sobrevida De Pacientes Oncológicos Com Cuidado Paliativo Precoce: Revisão De Literatura

Surgical Treatment of Esophageal Advanced Achalasia

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