Surgical treatment of relapsed megaesophagus

Bibliographic Details
Title: Surgical treatment of relapsed megaesophagus
Authors: COSTA, LUIGI CARLO DA SILVA, BRAGA, JOÃO GABRIEL ROMERO, TERCIOTI JUNIOR, VALDIR, COELHO NETO, JOÃO DE SOUZA, FERRER, JOSÉ ANTÔNIO POSSATTO, LOPES, LUIZ ROBERTO, ANDREOLLO, NELSON ADAMI
Source: Revista do Colégio Brasileiro de Cirurgiões. January 2020 47
Publisher Information: Colégio Brasileiro de Cirurgiões, 2020.
Publication Year: 2020
Subject Terms: Esophageal Achalasia, Heller Myotomy, Reoperation
More Details: Objective: to analyze the surgical treatment of patients with recurrent megaesophagus followed at the esophageal-stomach-duodenal outpatient clinic of the Hospital de Clínicas - UNICAMP. Methods: a retrospective study, from 2011 to 2017, with 26 patients with Chagas or idiopathic megaesophagus, surgically treated, and who recurred with dysphagia. Clinical, endoscopic and radiographic aspects were assessed and correlated with the performed surgical procedures. Results: 50% had dysphagia for liquids, 69% regurgitation, 65.3% heartburn, 69.2% weight loss and 69.2% had Chagas disease. In addition, 38.4% had megaesophagus stage 1 and 2 and 61.5% stage 3 and 4. Regarding the reoperations, 53% of them underwent Heller-Pinotti surgery by laparoscopy, Serra-Dória in 30.7% and esophageal mucosectomy in 7.9%. In 72% of the reoperations there were no postoperative complications, and 80% of the patients had a good outcome, with reduction or elimination of dysphagia. Among the reoperated patients undergoing the laparoscopic Heller-Pinotti technique, three reported little improvement of dysphagia in the postoperative period and among those who underwent Serra-Dória surgery, 100% had no dysphagia. It was observed that, when the time between the first procedure and the reoperation was longer, the better the surgical result was, with statistical significant decreased dysphagia (p=0.0013, p<0.05). Conclusions: there was a preference to perform laparoscopic re-miotomy and, as a second option, Serra-Dória surgery, for patients with recurrent megaesophagus. Esophagectomy or esophageal mucosectomy were reserved for more severe patients.
Document Type: article
File Description: text/html
Language: English
ISSN: 0100-6991
DOI: 10.1590/0100-6991e-20202444
Access URL: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912020000100167
Rights: info:eu-repo/semantics/openAccess
Accession Number: edssci.S0100.69912020000100167
Database: SciELO
More Details
ISSN:01006991
DOI:10.1590/0100-6991e-20202444
Published in:Revista do Colégio Brasileiro de Cirurgiões
Language:English