Surgical Treatment of Achalasia: Transabdominal Versus Transthoracic Cardiomyotomy

Bagheri, Reza; Haghi, Seyed Ziaollah; Noorshafiee, Sadjad

doi:10.5761/atcs.oa.09.01506

Cited by 2 publications

(1 citation statement)

References 20 publications

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“…It has been shown that fundoplication after myotomy prevents gastroesophageal reflux (GER). [ 10 ] On the other hand, Bagheri et al[ 11 ] revealed the positive aspects of the transthoracic approach and noted that GER symptoms were less present in the transthoracic group, compared to the transabdominal group, regardless whether the antireflux procedure was done or not. Moreover, robotic Heller myotomy without fundoplication showed excellent results.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous coronary artery disease and achalasia surgery: A novel approach

Benetis¹,

Budrikis²,

Gazdziauskas³

2021

Turk Gogus Kalp Dama

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A 69-year-old female patient presented to cardiac surgery department with unstable angina due to severe coronary artery disease. Coronary artery bypass grafting was indicated; however, the patient's symptoms of achalasia, previously treated by the pneumatic dilatation, exacerbated. Subsequently, the patient underwent simultaneous surgery. After sternotomy, on cardiopulmonary bypass, esophagus was exposed and Heller myotomy was performed. Following cardioplegia, coronary artery bypass grafting was completed. The postoperative course was uneventful, and the patient was discharged on postoperative Day 9. In conclusion, this novel surgical technique can be effectively used in such cases.

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Section: Discussionmentioning

confidence: 99%

Simultaneous coronary artery disease and achalasia surgery: A novel approach

Benetis¹,

Budrikis²,

Gazdziauskas³

2021

Turk Gogus Kalp Dama

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Determining long-term outcome of transthoracic Heller's myotomy when other methods fail: A single centere cases series

Baram

Essa

2019

International Journal of Surgery Open

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Objective: We aimed to estimate the long-term outcomes of transthoracic Heller's myotomy without fundoplication. Methods: This single centere, retrospective study included patients followed up for signs of cure, recurrence of symptoms, and different aspects of quality of life estimated over several years. Data were obtained directly from the patients and the medical records. The scores of patients with early and late dysphagia were compared preoperatively and postoperatively to estimate the quality of life (QoL). Results: A total of 48 patients (37 women and 11 men) who underwent surgery for achalasia between 2008 and 2018 were included. The mean age was 43.5 (19–68) years. The mean follow-up duration was 60.5 (1–120) months. Dysphagia, regurgitation, and heartburn were the most common symptoms, occurring in 100% of patients. The outcomes were an excellent success rate and estimation of QoL. After the first 6 months of follow-up, patients who underwent surgery developed grades 1–3 dysphagia. After 1–10 years of follow-up, 39 (81.25%) patients had grade 1 dysphagia, whereas 9 (18.75%) still had grade 2 dysphagia. During the long-term follow-up, only 77% of patients developed regurgitation, while 91.6% had heartburn. QoL changed according to dysphagia scores (from 5 to 1). However, the score of 26 patients (54.16%) decreased to 1; after 1 year of follow-up, 42 patients (87.5%) obtained a dysphagia score of 1. After 1–10 years of follow-up, 97.2% of patients underwent barium oesophagogram and showed a small-calibre oesophagus. Conclusion: Transthoracic Heller's myotomy is a safe and durable procedure that is associated with a durable long-term success rate and less recurrence, without necessity for any type of anti-reflux surgery. Highlights:

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Surgical Treatment of Achalasia: Transabdominal Versus Transthoracic Cardiomyotomy

Cited by 2 publications

References 20 publications

Simultaneous coronary artery disease and achalasia surgery: A novel approach

Simultaneous coronary artery disease and achalasia surgery: A novel approach

Determining long-term outcome of transthoracic Heller's myotomy when other methods fail: A single centere cases series

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