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Laparoscopic Heller-Dor Is an Effective Treatment for Esophageal-Gastric Junction Outflow Obstruction.
Salvador, Renato; Provenzano, Luca; Nezi, Giulia; Capovilla, Giovanni; Nicoletti, Loredana; Pierobon, Elisa Sefora; Moletta, Lucia; Valmasoni, Michele; Merigliano, Stefano; Costantini, Mario.
Afiliación
  • Salvador R; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, School of Medicine, Clinica Chirurgica 3, Azienda Ospedale Università di Padova, Padova, Italy. renato.salvador@unipd.it.
  • Provenzano L; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, School of Medicine, Clinica Chirurgica 3, Azienda Ospedale Università di Padova, Padova, Italy.
  • Nezi G; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, School of Medicine, Clinica Chirurgica 3, Azienda Ospedale Università di Padova, Padova, Italy.
  • Capovilla G; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, School of Medicine, Clinica Chirurgica 3, Azienda Ospedale Università di Padova, Padova, Italy.
  • Nicoletti L; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, School of Medicine, Clinica Chirurgica 3, Azienda Ospedale Università di Padova, Padova, Italy.
  • Pierobon ES; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, School of Medicine, Clinica Chirurgica 3, Azienda Ospedale Università di Padova, Padova, Italy.
  • Moletta L; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, School of Medicine, Clinica Chirurgica 3, Azienda Ospedale Università di Padova, Padova, Italy.
  • Valmasoni M; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, School of Medicine, Clinica Chirurgica 3, Azienda Ospedale Università di Padova, Padova, Italy.
  • Merigliano S; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, School of Medicine, Clinica Chirurgica 3, Azienda Ospedale Università di Padova, Padova, Italy.
  • Costantini M; Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, School of Medicine, Clinica Chirurgica 3, Azienda Ospedale Università di Padova, Padova, Italy.
J Gastrointest Surg ; 25(9): 2201-2207, 2021 09.
Article en En | MEDLINE | ID: mdl-33959877
BACKGROUND: The treatment of esophagogastric junction outflow obstruction (EGJOO) currently mirrors that of achalasia, but this is based on only a few studies on small case series. The aim of this prospective, controlled study was to assess the outcome of laparoscopic Heller-Dor (LHD) in patients with EGJOO, as compared with patients with esophageal achalasia. MATERIALS AND METHODS: Between 2016 and 2019, patients with manometric diagnosis of idiopathic EGJOO and patients with radiological stage I achalasia, both treated with LHD, were compared. The achalasia group was further analyzed by subgrouping the patients based on the manometric pattern. Treatment failure was defined as the persistence or reoccurrence of an Eckardt score > 3 or the need for retreatment. RESULTS: During the study period, 150 patients were enrolled: 25 patients had EGJOO and 125 had radiological stage I achalasia (25 pattern I, 74 pattern II, and 26 pattern III). The median follow-up was 24 months (IQR: 34-16). Treatment was successful in 96% of patients in the EGJOO group and in 96% of achalasia patients with pattern I, 98.7% in those with pattern II, and 96.2% of those with pattern III (p=0.50). High-resolution manometry showed a reduction in the LES resting pressure and integrated relaxation pressure for all patients in all 4 groups (p<0.001). CONCLUSION: This is the first comparative study based on prospective data collection to assess the outcome of LHD in patients with EGJOO. LHD emerged as an effective treatment for EGJOO, with an excellent success rate, comparable with the procedure's efficacy in treating early-stage achalasia.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Acalasia del Esófago / Laparoscopía Límite: Humans Idioma: En Revista: J Gastrointest Surg Asunto de la revista: GASTROENTEROLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Acalasia del Esófago / Laparoscopía Límite: Humans Idioma: En Revista: J Gastrointest Surg Asunto de la revista: GASTROENTEROLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos