1 ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 2012 Vol: 25(1):. DOI: 10.1590/S0102-67202012000100005

Esofagocardioplastia no tratamento cirúrgico do megaesôfago não avançado recidivado

BACKGROUND: It has always been very controversial to choose an ideal operation for patients with no advanced recurrent megaesophagus after previous treatment. The various existing techniques and the different degrees of disease are the major factors to this difficulty.AIM: To evaluate the early and late results of the Serra-Doria esophagocardioplasty in patients who had recurrence of symptoms in non-advanced megaesophagus after having been submitted to cardiomyotomy.METHODS: Were studied 32 patients. The age ranged from 32 to 63 years. Nineteen had mild and 13 moderate dysphagia, and 14 had some degree of regurgitation. These subjects underwent the Serra-Doria esophagocardioplasty and were evaluated the local and systemic complications occurred postoperatively.RESULTS: After the procedure could be followed 27 patients, 22 began to show normal swallowing, five mild dysphagia and three remained with some regurgitation. No patient died. Three had early pneumonia and in one occurred anastomotic leak.CONCLUSIONS: The Serra-Doria esophagocardioplasty is adequate procedure for the surgical treatment of relapsed non advanced megaesophagus.

Mentions
Altmetric
References
  1. Alves L, Zilberstein B, Trevenzol HP, Penhavel FAZ, Neder J. Operação de SERRA-DÓRIA no tratamento do megaesôfago chagásico avançado: resulta.dos imediatos. Arq. Bras Cir Dig 16(3) , 120-23 (2003) .
  2. Aquino JLB , Said MM, Pereira EVA, Vernachi B, Oliveira MB. Terapêutica cirúrgica do Megaesôfago Recidivado. Revista do Colégio Brasileiro de Cirurgiões 34(5) , 310-313 (2007) .
  3. Aquino JLB, Reis Neto JA, Muraro COM, Camargo JGT. Mucosectomia esofágica no tratamento do megaesôfago avançado: analise de 60 casos. Revista do Colégio Brasileiro de Cirurgiões. 27 , 109-16 (2000) .
  4. Aquino JLB, Said MM, Crisostomo T, Maziero D, Oliveira JP. Avaliação tardia da remiotomia em pacientes com megaesôfago não avançado com recidiva de sintomas. Rev Col Bras Cir. 1 , 7-8 (2009) .
  5. Barbosa H, Barichello AW, Mendelssonh P, Viana AL, Watanabe LM. Tratamento cirúrgico do megaesôfago chagásico: duas décadas de experiência numa região endêmica . Rev. Goiana Med. 1989 35, 1-23 .
  6. Bonatti H, Hinder RA, Klocker J, Neuhauser B, Klaus A, Achem SR. Long-term results of laparoscopic Heller myotomy with partial fundoplication for treatment of achalasia. Am J Surg 190 , 874-8 (2005) .
  7. Csendes A. Results of surgical treatment of achalasia of the esophagus. Hepatogastroenterology 1991: 38: 474 -80 , .
  8. Dias JC, Silveira AC, Schfield CJ. The impact of Chagas disease control in Latin America: a review. Mem. Instituto Oswaldo Cruz. 2002, 97(5) , 603-12 .
  9. Goldenberg S. Cirurgia do megaesofago - operação de Grondhal Doria modificada. Rev. Goiania Med. 19 , 195-201 (1973) .
  10. Gröndahl NB. Cardiaplastik Ved Cardiospasmus. Nord Kirurgisk Forenings 11 , 236-40 (1916) .
  11. Grotenhius BA, Wijnhoven BPL, Myers JC, Jamieson GG, Devitt PG, Watson DI. Reoperation for dysphagia after cardiomyotomy for achalasia. The Ameican Journal of Surgery 194 , 678-82 (2007) .
  12. Herbella FAM, Del Grande JC, Lourenço LG, Mansur NS, Haddad CB. Resultados tardios da operação de Heller associada a fundoplicatura no tratamento do megaesôfago: analise de 83 casos. Rev. Associação Médica Brasileira 45 , 17-22 (1999) .
  13. Holt CJ, Large AM. Surgical management of reflux esophagitis. Ann Surg 153 , 555-63 (1961) .
  14. Martins P, Morais BB, Cunha Mello JR. Postoperative Complications in the treatment of Chagasic Megaesophagus. Int. Surg. 78 , 99-102 (1993) .
  15. Miller DL, Allen MS, Trastek VF. Esophageal ressection for recurrent Achalasia. Ann Thoracic Surgery 60 , 992-6 (1995) .
  16. Orringer MB, Marshall B, Chang AC, Lee J, Pickens A, Lau CL. Two Thousand Transhiatal Esophagectomies. Changing Trends, Lessons learned. Ann Surg 246 , 363-374 (2007) .
  17. PEARSON FG. Achalasia - Long Term Follow -up and late complications. Brasilia Med. 32(3/4): 34:36 , (1995) .
  18. Ponciano H, Ceconello I, Alves L, Ferreira BD, Gama-Rodrigues JJ. Cardioplasty and Roux in Y parcial gastrectomy (Serra-Dória procedure) for reoperation of achalasia. Arq. Gastroenterol. 41(3) , 155-61 (2004) .
  19. Ramos DM, Sos JE, Yepes VA, Sanchis JLS. Tecnica de Serra-Dória: Um buen recurso para el tratamiento de la acalasia esofágica recidivada. Cir. Esp. 80(5) , 340-4 (2006) .
  20. Rezende JM, Lauar KM, Oliveira AR. Aspectos clínicos e radiológicos da aperistalse do esôfago. Rev Bras.Gastroenter 12 , 247-51 (1960) .
  21. Richards WO, Torquati A, Holzman M. Heller myotomy versus Heller myotomy with Dor fundoplication for Achalasia: a prospective randomized double- blind clinical trial. Ann Surg. 2004: 240(3) , 412-5 .
  22. Serra HO, Felix VN, Ceconello I, Pinotti HW. Reaplication of Myotomy and fundoplication in the surgical treatment of recurrent dysphagia after incomplete myotomy. Rev Hosp Clin Fac Med São Paulo 53 , 129-33 (1998) .
  23. Serra-Dória OB, Silva-Dória OM, Silva-Dória OR. Nova conduta cirurgica para o tratamento do megaesôfago.An Paul Med Cir97:115 -21 , (1970) .
  24. Serra-Dória OB, Silva-Dória OM, Silva-Dória OR. Operação de Serra-Dória para tratamento do megaesôfago. Considerações quanto a originalidade do método. An Paul Med Cir. 99 , 113-20 (1972) .
  25. Serra-Dória OB. Tratamento cirugico do megaesofago. Operação de Serra-Dória. Rev. Goiania Med 19:.Correspondence: José Luis Braga de Aquino e-mail: jlaquino@sigmanet.com.brFinancial source: none Conflicts of interest: none From Service of Surgery, Celso Pierro Hospital, Faculty of Medicine, Catholic University of Campinas (HMCP-FCM-PUC), Campinas, SP, Brasil , 185-93 (1973) .
Expand