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Esophageal miotomy

Anca Dimitriu, Cristian Gheorghe
High resolution manometry (HRM) is currently the gold standard for the diagnosis of achalasia and other functional esophageal disorders. All patients accusing dysphagia should be endoscopically evaluated prior to manometric investigations in order to rule out pseudoachalasia. The Chicago HRM classification has led to a subclassification of three manometric types of achalasia that seem to have different results to treatment. None of the actual achalasia treatment options are curative. Type II achalasia patients respond best to all treatment options compared to those with types I and III...
January 2018: Chirurgia
Renato Micelli Lupinacci, Antonio Carlos Pereira Lima, Renato Arioni Lupinacci
Zenker's diverticulum is a pseudodiverticulum through a muscular defect in the posterior pharyngeal wall at the area between the inferior pharyngeal constrictor muscles of the pharynx and the cricopharyngeus muscle. Although endoscopic techniques have made significant progress, the surgical treatment remains the gold standard. There are two main techniques: diverticulectomy (resection of the diverticulum) and diverticulopexy. The main advantages of diverticulopexy are mostly linked to the absence of an esophageal anatomosis and its possible complications: cervical fistulae, mediastinitis, esophageal stenosis and wound infection, which allows a rapid recover with satisfactory oral intake...
January 2013: Revista do Colégio Brasileiro de Cirurgiões
S Bonventre, M Frazzetta, M Lucania, F Frazzetta, A S Sciortino, D Sammartano, G Vetri, G Di Gesù
INTRODUCTION: The authors report their experience about the intraoperative manometry in the achalasia surgical treatment. PATIENTS AND METHODS: We have considered 239 patients with achalasia observed from 1994 to 2006; only 79 continued the path diagnostic therapeutic and 31 underwent Heller longitudinal miotomy, with Dor anti-reflux plastic in 25 patients and in 6 Nissen anti-reflux plastic. In 24 we performed the intraoperative manometry (MI) recording the high pressure areas...
August 2008: Il Giornale di Chirurgia
R Vecchio, F Palazzo, F Di Franco, M Arcerito, A Consoli, S Latteri
The Authors report their experience on 76 patients managed for oesophageal achalasia from 1973-1997. 65 patients have been surgically treated with Heller miotomy (19 cases) or miotomy with antireflux procedures (46 cases); 11 patients underwent an endoscopic pneumatic dilation. 54 patients, 43 surgically and 11 endoscopically treated, have been followed for a mean length of time of 6 years and 6 months. Complete cure or significant improvement of symptoms have been noted in 86% and 72.7% of patients treated respectively with surgery or pneumatic dilatation...
August 1999: Il Giornale di Chirurgia
Z Gerzić
A total of 356 patients were treated for achalasia during a thirty eight years period, ranging from 1955 to 1993 the author presents his results and therapeutic recommendations. Since 1970, patients were treated in a standardized manner, using the transabdominal approach in 85,71% patients and the transthoracic approach in 14,29% pts. The operative technique for cardiomiotomy is described in detail for both approaches. To achieve good postoperative result it is necessary, to perform complete miotomy in a length of 6-8 cm...
1995: Acta Chirurgica Iugoslavica
P R Mioli, M Dei Poli
The authors, on a basis of experience acquisted since 1984 on two groups of patients, respectively 55 and 174 subjects with angina like chest-pain, individuated in the first group 45%, and 66.1% in the second group, the presence of GER-EMD with the execution of functional stationary manometric and 24 hour pH-metrical exams, without undergoing chemical, pharmacological, mechanical stimulation. They make note that 43 patients out of the second group, underwent, after a certain time, another cardiological study (negative for heart disease when recluted) due to graveness of the symptoms and 33 risulted holders of heart disease, 24 of whom also affected with EMD...
September 1995: Annali Italiani di Chirurgia
F P Mattioli, N Pandolfo, L Spigno, P L Bozzano, U Tassone
From 1962 to 1992 sixtythree patients with esophageal achalasia underwent primary surgical treatment. The intervention performed was a cardiomiotomy according to Heller in 20 patients (Group A), a cardiomiotomy according to Heller with anti-reflux procedure according to Lortat-Jacob in 12 patients (Group B), a cardiomiotomy according to Heller with fundoplicatio according to Dor in 31 patients (Group C). Preoperative study was performed by radiological evaluation in patients of Group A, while patients of Group B and Group C were submitted also to endoscopy and esophageal manometry...
September 1995: Annali Italiani di Chirurgia
G Zaninotto, M Anselmino, M Costantini, C Boccù, S Merigliano, M Rossi, E Ancona
Extramucosal myotomy involving the external longitudinal and internal circular layers of the musculature of the esophagus represent the surgical therapy in patients with dysphagia and regurgitation or with angina-like chest pain secondary to functional abnormalities of the musculature of the esophagel body and sphincters. Surgery has a palliative function, because cures symptoms and complication such a diverticula, but not the disease. Modern surgical techniques also prevent recurrence of symptoms and complications are minimal with better long-term results than conservative therapy...
September 1995: Annali Italiani di Chirurgia
R de Dios, J C Chiocca, J C Cornicelli, G B Salis
A case of uncommon occurrence, such as the so called primary achalasia and hypertension of the cricopharyngeal sphincter is hereby described, as well as its successful treatment by means of an extramucous miotomy of the cricopharyngeal sphincter. The anatomy and physiology of the upper esophageal sphincter is described, as well as its pathogenesis. The published literature is also reviewed.
1981: Acta Gastroenterologica Latinoamericana
J C de Almeida, J M de Almeida
Miotomy is the most common operation for the treatment of achalasia of the esophagus. The most important complication of this operation is gastro-esophageal reflux, and controversy exists in the choice of a thoracic or abdominal approach to this operation. From 1974 until 1988, our group performed 45 miotomies for achalasia of the esophagus. Follow-up was obtained in 82% of the patients. The thoracic approach was used in 21 cases (tor), and 24 patients were operated through an abdominal approach (abd). All the miotomies had an anti-reflux procedure associated...
October 1992: Acta Médica Portuguesa
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