Treatment challenges of sigmoid-shaped esophagus and severe achalasia.
Achalasia
Esophagectomy
Heller's myotomy with dor fundoplication
Severe achalasia
Sigmoid esophagus
Journal
Annals of medicine and surgery (2012)
ISSN: 2049-0801
Titre abrégé: Ann Med Surg (Lond)
Pays: England
ID NLM: 101616869
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
09
11
2020
revised:
28
11
2020
accepted:
28
11
2020
entrez:
28
12
2020
pubmed:
29
12
2020
medline:
29
12
2020
Statut:
epublish
Résumé
Achalasia is a chronic motility disorder which may require surgical interventions to effectively manage patients' symptoms and improve functional status. In late stage achalasia, patients may present with sigmoid-shaped esophagus which complicates traditional treatment approaches for achalasia as the esophagus is massively dilated and dysfunctional with delicate tissue integrity. Severe Achalasia with sigmoid esophagus imposes significant challenge to surgeons and treating physicians. Various assessment modalities and treatment approaches have been tried. Surgical treatment continues to be controversial. Some have argued that a less aggressive approach similar to that in early Achalasia results in satisfactory outcomes. Others have argued a more aggressive approach of esophagectomy is necessary. We present a review of the challenges encountered in each approach with recommendation for selecting the right treatment for the individual cases. Different treatment options for sigmoid type achalasia are available with ongoing controversy among the options. Heller myotomy with Dor fundoplication can provide satisfactory symptoms improvement and treatment outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Achalasia is a chronic motility disorder which may require surgical interventions to effectively manage patients' symptoms and improve functional status. In late stage achalasia, patients may present with sigmoid-shaped esophagus which complicates traditional treatment approaches for achalasia as the esophagus is massively dilated and dysfunctional with delicate tissue integrity. Severe Achalasia with sigmoid esophagus imposes significant challenge to surgeons and treating physicians. Various assessment modalities and treatment approaches have been tried. Surgical treatment continues to be controversial. Some have argued that a less aggressive approach similar to that in early Achalasia results in satisfactory outcomes. Others have argued a more aggressive approach of esophagectomy is necessary. We present a review of the challenges encountered in each approach with recommendation for selecting the right treatment for the individual cases.
CONCLUSIONS
CONCLUSIONS
Different treatment options for sigmoid type achalasia are available with ongoing controversy among the options. Heller myotomy with Dor fundoplication can provide satisfactory symptoms improvement and treatment outcomes.
Identifiants
pubmed: 33363724
doi: 10.1016/j.amsu.2020.11.077
pii: S2049-0801(20)30504-5
pmc: PMC7750448
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
30-34Informations de copyright
© 2020 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.
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