Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
, 9 (3), 204-8

Oesophagectomy in the Management of End-Stage Achalasia - Case Reports and a Review of the Literature

Affiliations
Review

Oesophagectomy in the Management of End-Stage Achalasia - Case Reports and a Review of the Literature

Julia M Howard et al. Int J Surg.

Abstract

Achalasia is an oesophageal motility disorder characterised by aperistalsis and failure of relaxation of a hypertensive lower oesophageal sphincter. Treatment intent targets the sphincter, and either Heller's myotomy or pneumatic dilatation successfully relieves dysphagia in the majority of cases. End-stage achalasia, typified by a massively dilated and tortuous oesophagus, may occur in patients previously treated but where further dilatation or myotomy fails to relieve dysphagia or prevent nutritional deterioration, and oesophagectomy may be the only option. We describe two patients with end-stage achalasia and nutritional failure despite exhaustive conventional therapy including pneumatic dilatation and surgical myotomy. Both patients were successfully managed with transhiatal oesophagectomy and cervical gastro-esophageal anastomosis, with excellent symptomatic control and improved quality of life. These cases are discussed and the literature reviewed.

Similar articles

  • Thoracoscopic Oesophagectomy for End-Stage Achalasia
    VK Varshney et al. J Minim Access Surg 14 (3), 253-255. PMID 29319022. - Case Reports
    Achalasia cardia is an oesophageal motility disorder characterised by aperistalsis and failure of relaxation of the lower oesophageal sphincter. The management is predomi …
  • [Failure of Surgical Treatment for Achalasia: Diagnosis and Treatment]
    A Del Genio et al. Ann Ital Chir 66 (5), 587-95. PMID 8948795. - Clinical Trial
    After a wide revision of the Literature, the most frequent causes of failure in the surgical therapy of esophageal achalasia are described. Above all there is the uncorre …
  • Laparoscopic Stapled Cardioplasty for Failed Treatment of Achalasia
    TC Dehn et al. Br J Surg 99 (9), 1242-5. PMID 22864884.
    LSC may be a useful procedure for resistant achalasia.
  • Management of Achalasia: Surgery or Pneumatic Dilation
    JE Richter et al. Gut 60 (6), 869-76. PMID 21303915. - Review
    Achalasia is an esophageal motility disorder of unknown cause, characterised by aperistalsis of the esophageal body and impaired lower esophageal sphincter relaxation. Pa …
  • Surgical Management of End-Stage Achalasia
    D Molena et al. Semin Thorac Cardiovasc Surg 24 (1), 19-26. PMID 22643658. - Review
    Esophageal achalasia is a chronic and progressive motility disorder that leads to massive esophageal dilation when left untreated. Treatment for achalasia is palliative a …
See all similar articles

Cited by 5 PubMed Central articles

LinkOut - more resources

Feedback