背景:带胃底折叠术的视频腹腔镜食管心肌切开术已成为治疗门失弛缓症的一种广泛使用的技术。这项研究分析了该技术在巴西联邦大学公立医院治疗非晚期门失弛缓症(大食道)的安全性和有效性。
目的:评估巴西公立大学医院电视腹腔镜治疗非晚期大食道的短期和长期结果,采用食管心肌切开术与胃底折叠术。
方法:在UFU-MG联邦大学临床医院接受非晚期门失弛缓症手术治疗的44例患者的病历,米纳斯吉拉斯州,2001年1月至2021年7月进行了分析。评估了以下数据:性别,年龄,病因学,Rezende-Alves和Ferreira-Santos的放射学分类,即时和晚期并发症(平均随访31.4个月),是否需要转换为开放访问,术后反流,术前是否有内镜下食管扩张,术后死亡率,术前和术后症状的频率(持续性吞咽困难,返流,胃灼热,呕吐,吞咽困难,和体重减轻),手术时间,住院,吞咽困难的持续时间,术前术后体重,和Eckardt得分。
结果:在分析的患者中,23人(52.3%)为男性,21名(47.7%)为女性,平均年龄50.8岁.未记录到早期并发症,有27.2%的晚期胃食管反流病例。术后体重增加为81.8%,根据Eckardt评分的手术成功率为84.1%。
结论:食管心肌切开术联合胃底折叠术是治疗非晚期门失弛缓症的一种安全有效的方法。
BACKGROUND: Videolaparoscopic esophagocardiomyotomy with
fundoplication has been a widely used technique for the treatment of achalasia. This study analyzes the safety and effectiveness of the technique in the treatment of non-advanced achalasia (megaesophagus) in a Brazilian federal university public hospital.
OBJECTIVE: To evaluate the short- and long-term results of videolaparoscopic treatment of non-advanced megaesophagus in a public university hospital in Brazil, employing the esophagocardiomyotomy technique with
fundoplication.
METHODS: The medical records of 44 patients who underwent surgical treatment for non-advanced achalasia at the Clinical Hospital of Federal University of Uberlândia (UFU-MG), Minas Gerais, from January 2001 to July 2021 were analyzed. The following data were evaluated: gender, age, etiology, radiological classification of Rezende-Alves and Ferreira-Santos, immediate and late complications (mean follow-up of 31.4 months), need or not for conversion to open access, postoperative reflux, performance or not of endoscopic esophageal dilation in the preoperative period, postoperative mortality, frequency of pre and postoperative symptoms (persistent dysphagia, regurgitation, heartburn, vomiting, odynophagia, and weight loss), surgery time, hospital stay, duration of dysphagia, pre and postoperative weight, and Eckardt score.
RESULTS: Among the analyzed patients, 23 (52.3%) were male, and 21 (47.7%) were female, with a mean age of 50.8 years. No early complications were recorded and there were 27.2% cases of late gastroesophageal reflux. Postoperative weight gain was 81.8% and the success rate of surgery according to the Eckardt score was 84.1%.
CONCLUSIONS: Esophagocardiomyotomy with
fundoplication is an effective and safe technique for the treatment of non-advanced achalasia.