TITLE

Pneumatic Dilatation or Laparoscopic Cardiomyotomy in the Management of Newly Diagnosed Idiopathic Achalasia

AUTHOR(S)
Kostic, S.; Kjellin, A.; Ruth, M.; Lönroth, H.; Johnsson, E.; Andersson, M.; Lundell, L.
PUB. DATE
March 2007
SOURCE
World Journal of Surgery;Mar2007, Vol. 31 Issue 3, p470
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The most effective therapeutic strategy in newly diagnosed achalasia is yet to be established. Therefore we designed a study in which pneumatic dilatation was compared to laparoscopic cardiomyotomy to which was added a partial posterior fundoplication. A series of 51 patients (24 males, mean age 44 years) were randomly allocated to the therapeutic modalities (dilatation = 26, surgery = 25). All patients were followed for at least 12 months, and during that period the pneumatic dilatations strategy had significantly more treatment failures ( P = 0.04). Only minor differences emerged between the study groups when symptoms, dysphagia scorings, and quality-of-life assessments were evaluated 12 months after initiation of therapy. Laparoscopic myotomy was found to be superior to an endoscopic balloon dilatation strategy in the treatment of achalasia when studied during the first 12 months after treatment.
ACCESSION #
24240888

 

Related Articles

  • Evaluation and Management of Postfundoplication Dysphagia. Wo, John M.; Trus, Ted L.; Richardson, William S.; Hunter, John G.; Branum, Gene D.; Mauren, Susan J.; Waring, J. Patrick // American Journal of Gastroenterology;Nov1996, Vol. 91 Issue 11, p2318 

    Objectives: Persistent dysphagia occurs in 3-24% of patients alter fundoplication. There are virtually no data on the success or safety of endoscopic dilation to relieve postfundoplication dysphagia. the aim of this study was to review our experience with endoscopic management of patients with...

  • Case & Comment. Reddy, Sangeetha; Nachimuthu, Senthil; Moola, Kalyani // Patient Care for the Nurse Practitioner;Sep2002, Vol. 5 Issue 9, p1 

    The article presents a diagnosis of a 29-year-old Hispanic woman, who complains of having intermittent dysphagia with solids for 4 years. She had a spontaneous abortion at 6 weeks gestation and underwent a dilation and curettage a month prior to presentation. She claims to have heavy menstrual...

  • Successful Outcome After Laparoscopic Heller Myotomy And Dor Fundoplication Avoiding Esophageal Resection In A Patient With Megaesophagus And Advanced Idiopathic Achalasia. Balaguera, J. Carvajal; Segovia, J. Camu�as; Garc�a-Almenta, M. Mart�n; de Torres, S. Oliart Delgado; Aguiriano, L. Albeniz; Gamarra, L. Pe�a; Hern�ndez, C.Ma. Cerquella // Internet Journal of Surgery;2007, Vol. 12 Issue 2, p8 

    Laparoscopic Heller myotomy and Dor fundoplication is the surgical procedure of choice for esophageal achalasia. However, treatment of megaesophagus for advanced idiopathic achalasia has been controversial. Some authors recommend a myotomy as initial treatment and reserve esophageal resection...

  • Patient Outcomes and Dysphagia after Laparoscopic Antireflux Surgery Performed without Use of Intraoperative Esophageal Dilators. Walsh, Jason D.; Landercasper, Jeffrey; Boyd, William C.; Lambert, Pamela J.; Havlik, Paul J. // American Surgeon;Mar2003, Vol. 69 Issue 3, p219 

    Esophageal dilators (EDs) are commonly used during antireflux surgery but are a known cause of esophageal perforation. We hypothesized that the usage of ED during laparoscopic fundoplications (LFs) would not improve dysphagia rates or outcome. A retrospective review of 268 consecutive patients...

  • Dsyphagia Following Fundoplication: "Slipped" Fundoplication versus Achalasia Complicated by Fundoplication. Mattox, Huitt E.; Albertson, David A.; Castell, Donald O.; Richter, Joel E. // American Journal of Gastroenterology;Nov1990, Vol. 85 Issue 11, p1468 

    Failure to obtain preoperative esophageal manometry in patients being considered for antireflux surgery can result in immediate persistent postoperative dysphagia due to a missed diagnosis of achalasia. We describe the clinical assessment and management of a case of delayed postoperative...

  • Clinical Trials Evaluating Endoscopic GERD Treatments Is It Time for a Moratorium on the Clinical Use of These Procedures? Hogan, Walter J. // American Journal of Gastroenterology;Mar2006, Vol. 101 Issue 3, p437 

    Perendoscopic treatments of gastroesophageal reflux have been used in clinical practice following FDA approval of the first two devices in 2000. A number of clinical trials predominantly short-term have been performed almost uniformly demonstrating patient improvement in GERD symptomatology and...

  • Ten-year follow-up of laparoscopic Heller myotomy for achalasia shows durability. Jeansonne, Louis O.; White, Brent C.; Pilger, Kelly E.; Shane, Matthew D.; Zagorski, Stanley; Davis, S. Scott; Hunter, John G.; Lin, Edward; Smith, C. Daniel // Surgical Endoscopy;Sep2007, Vol. 21 Issue 9, p1498 

    Objective: Reports of long-term outcomes for laparoscopic Heller myotomy (LHM) are scarce. In this work, outcomes of LHM for achalasia in patients who underwent surgery more than 10 years prior were investigated.Methods: A cohort of patients treated with LHM and partial...

  • Endoscopic and symptomatic assessment of anastomotic strictures following esophagectomy and cervical esophagogastrostomy. Williams, V. A.; Watson, T. J.; Zhovtis, S.; Gellersen, O.; Raymond, D.; Jones, C.; Peters, J. // Surgical Endoscopy;Jun2008, Vol. 22 Issue 6, p1470 

    Dysphagia following esophagectomy with cervical esophagogastric anastomosis is common and often can be attributed to anastomotic stricture. The prevalence, risk factors, symptomatic and endoscopic severity, and response to dilation of such strictures, however, are poorly defined. In the present...

  • DYSPHAGIA CLINIC. Esophageal spasm. O'Rourke, Ashli K.; Weinberger, Paul M.; Postma, Gregory N. // ENT: Ear, Nose & Throat Journal;Nov2011, Vol. 90 Issue 11, p516 

    The article presents a case study of a 58-year-old man with esophageal spasm (ES). High-resolution manometry (HRM) revealed severe (ES) of the distal segments of the esophagus with sustained intraesophageal pressures of about 120 millimeter (mm). Among the cited symptoms of ES are chest pain and...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics