Revisional Surgery after Heller Myotomy for Treatment of Achalasia: A Comparative Analysis Focusing on Operative Approach

被引：7

作者：

Gouda, Biswanath P. ^{[1
]}

Nelson, Thomas ^{[2
]}

Bhoyrul, Sunil ^{[3
]}

机构：

[1] PD Hinduja Natl Hosp & Med Res Ctr, Dept Gen Surg, Mumbai 400016, Maharashtra, India

[2] Naval Hosp Camp Pendleton, Dept Minimally Invas Surg, Camp Pendleton, CA USA

[3] Scripps Mem La Jolla, Dept Gen & Minimally Invas Surg, La Jolla, CA 92037 USA

来源：

INDIAN JOURNAL OF SURGERY | 2012年 / 74卷 / 04期

关键词：

Achalasia; Heller myotomy; Revisional surgery; ESOPHAGEAL ACHALASIA; LAPAROSCOPIC SURGERY; FAILED ESOPHAGOMYOTOMY; ANTIREFLUX PROCEDURE; FOLLOW-UP; FUNDOPLICATION; REOPERATION; EXPERIENCE; MANAGEMENT; FEATURES;

D O I：

10.1007/s12262-011-0402-7

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Surgical myotomy is the gold standard in therapy for achalasia, but treatment failures occur and require revisional surgery. A MEDLINE search of peer-reviewed articles published in English from 1970 to December 2008 was performed using the following terms: esophageal achalasia, Heller myotomy, and revisional surgery. Thirty-three articles satisfied our inclusion criteria. A total of 12,727 patients, with mean age of 43.3 years (males 46% and females 50%), underwent Heller myotomy (open 94.8% and laparoscopic 5.2%). Revisional surgery was performed in 6.19%. Procedures performed included revision of the original myotomy or creation of a new myotomy with or without an antireflux procedure or esophagectomy. Reasons for reoperation were incomplete myotomy (51.8%), onset of reflux (34%), megaesophagus (16.2%), and esophageal carcinoma (3.04%). Systematic review of the literature for revisional surgery following Heller myotomy revealed a 6.19% rate of reoperation with a low mortality rate.

引用

页码：309 / 313

页数：5

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